Physical Therapist Education Programs Research Articles

Benchmarking the Physical Therapist Academic Environment to Understand the Student Experience.

Identifying excellence in physical therapist academic environments is complicated by the lack of nationally available benchmarking data. The objective of this study was to compare a physical therapist academic environment to another health care profession (medicine) academic environment using the Association of American Medical Colleges Graduation Questionnaire (GQ) survey. The design consisted of longitudinal benchmarking. Between 2009 and 2017, the GQ was administered to graduates of a physical therapist education program (Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa [PTRS]). Their ratings of the educational environment were compared to nationwide data for a peer health care profession (medicine) educational environment. Benchmarking to the GQ capitalizes on a large, psychometrically validated database of academic domains that may be broadly applicable to health care education. The GQ captures critical information about the student experience (eg, faculty professionalism, burnout, student mistreatment) that can be used to characterize the educational environment. This study hypothesized that the ratings provided by 9 consecutive cohorts of PTRS students (n = 316) would reveal educational environment differences from academic medical education. PTRS students reported significantly higher ratings of the educational emotional climate and student-faculty interactions than medical students. PTRS and medical students did not differ on ratings of empathy and tolerance for ambiguity. PTRS students reported significantly lower ratings of burnout than medical students. PTRS students descriptively reported observing greater faculty professionalism and experiencing less mistreatment than medical students. The generalizability of these findings to other physical therapist education environments has not been established. Selected elements of the GQ survey revealed differences in the educational environments experienced by physical therapist students and medical students. All physical therapist academic programs should adopt a universal method to benchmark the educational environment to understand the student experience.

Identifying Demographic and Preadmission Factors Predictive of Success on the National Physical Therapy Licensure Examination for Graduates of a Public Physical Therapist Education Program

Background and Purpose. A primary outcome of concern to the California State University, Sacramento physical therapy program is the ability of graduates to pass the National Physical Therapy Examination (NPTE) for licensure. The purpose of this case study was to identify the predictive strength of preadmission demographic factors, academic performance, and standardized test scores in graduates' ability to pass the NPTE. Case Description. Preadmission data from 11 years of graduates from a single Master of Physical Therapy (MPT) program (n = 320) were analyzed, including prerequisite grade point average (pGPA), analytic Graduate Record Examination (GRE), verbal GRE and quantitative GRE (qGRE) scores, sex, English as a second language (ESL) status, and NPTE test results. The bivariate association of each preadmission variable to NPTE success was assessed, and receiver operating characteristic curve analysis was performed to determine the optimal cutoff score of each continuous variable. Multifactor logistic regression analysis was performed to determine which independent variables were most predictive of NPTE success. Outcomes. Of the 320 MPT graduates, 284 (88.7%) passed the NPTE on the first attempt and 305 (95.3%) passed on the first or second attempt. Of all MPT graduates, 182 (57%) were females, and 57 (18%) reported that English was their second language. All three of the GRE subscale average scores, pGPA, and ESL were significantly associated with NPTE outcomes. Persons with ESL were significantly more likely to need more than one attempt to pass the NPTE. The qGRE score was found to be the strongest predictor of NPTE outcomes in the multifactor logistic regression analysis, whether looking at first-time passing rates or second-time pass rates. Discussion and Conclusion. The strongest preadmission variable for NPTE success was the qGRE score of ≥29th percentile, and this cutoff score explained the variance predicted by ESL and pGPA. The admission committee used this data to implement an evidence-based admission's minimum threshold for qGRE. This case is an example of how a physical therapist education program can analyze its own data to apply evidence to its admission criteria that best serve the mission of the program.

Faculty-Lived Experiences Integrating Technology-Assisted Educational Practices Into an Entry-Level Physical Therapy Curriculum

Introduction. Across the nation, innovative technologies have changed instructional practices throughout higher education. In physical therapist education programs, faculty must work to integrate technology into a complex academic curriculum that prepares students to be hands-on health care practitioners. The purpose of this study was to uncover how physical therapy (PT) faculty make sense of their lived experiences integrating innovative technology-assisted educational practices into their entry-level curriculums. Methods. Ten participants were recruited from the PT department at an urban university in the northeastern United States. An interpretative phenomenological analysis was used to explore participants' experiences and gather data through individualized, semistructured interviews. Results. Data analysis yielded three superordinate themes: awareness of barriers, appreciation for educational contributions, and respect for program integrity. Findings revealed that faculty experienced internal and external barriers that affected technology integration efforts. In addition, they were encouraged by the ability of technology to reach diverse learners and promote metacognition and were enthusiastic about the pedagogical advantages of student input. Furthermore, in-person instruction and intentional, judicious technology integration was perceived as crucial to program integrity. Discussion and Conclusion. Exploration of faculty experiences gave rise to a unique subtheme of sense of dependence as a barrier that has not been directly reported in the literature. Similarly, respect for program integrity formed a unique superordinate theme that is worthy of future research. Findings are relevant to administrators and PT faculty as they work to advance quality pedagogy. They are also of value to technical support specialists because they strive to provide technology-based training and guidance and of value to students because they seek to expand their knowledge.

Staphylococcus and MRSA Prevalence in Physical Therapist Education Programs: Are Students at Risk?

Introduction. Staphylococcus skin infections including methicillin-resistant Staphylococcus aureus (MRSA) are a major health concern in clinical and nonclinical settings where skin-to-skin and skin-to-surface contacts are frequent. This type of contact is inherent in entry-level physical therapy education laboratory classrooms, putting students at risk for exposure to harmful bacteria. With only one previous study examining the prevalence of Staphylococcus at a single program, the purpose of this study was to expand the study across multiple academic centers to further explore the presence of Staphylococcus and exposure risk in our laboratory classrooms. Methods. Four entry-level physical therapist education programs participated in the study. Swab samples were collected from plinths located in laboratory classrooms at each of the four academic sites and processed according to the previously documented protocol at each of the four academic sites. Results. Of the 333 total samples, 47 (14.1%) tested positive for S. aureus, 2 samples were positive for MRSA (0.06%). Although all four programs reported their laboratory classrooms were “multiuse,” the classrooms with the highest utilization had the highest prevalence of S. aureus. Discussion and Conclusion. Close quarters and frequent skin-to-skin and skin-to-surface contacts in physical therapist education increases student exposure risk to harmful bacteria. This risk increases in multiuse or high utilization laboratory classrooms. Education programs must develop and implement strong laboratory classroom disinfection protocols to protect students, faculty, and staff as well as the patients, family, and community members they may encounter. This simple environmental scan further highlights the need for additional multifacility screening regarding the prevalence of harmful bacteria in laboratory classrooms and close examination of cleaning protocols.

Survey of Disability Competence Teaching and Assessment Strategies in Physical Therapist Education

Introduction. Current research indicates that health care professionals' biased attitudes toward people with disabilities (PWDs) may contribute to increased health care disparities and poorer quality of care. Targeted disability competence education may improve this situation. The 4 specific purposes of this study were to identify (1) the disability competencies physical therapist education program faculty identified as relevant to physical therapist education; (2) the disability competencies physical therapist programs addressed; (3) the training strategies physical therapist educators used to promote disability competence; and (4) the assessment strategies used to evaluate disability competence. Methods. Faculty members of entry-level Doctor of Physical Therapy programs in the United States (US) with the most knowledge of each program's disability-related curricula. An online survey was developed based on a review of the literature, and then e-mailed to program directors. Respondents were faculty members of entry-level Doctor of Physical Therapy programs in the United States (US) with the most knowledge of each program's disability-related curricula. Survey responses were summarized through frequencies and means; open-ended responses were analyzed using content analysis. Results. Eighty-four surveys were completed in part or whole for a final response rate of 38.7%. Most respondents (78.6%) stated that they include “disability” in the framework of “cultural competence,” but only 9.5% of respondents reported that their programs used the term “disability competence.” The majority used the listed teaching methods except for planned community-based interactions with PWDs. Discussion and Conclusion. This study was the first to explore approaches to disability competence in US-based physical therapist education programs. However, further research is indicated to determine the most effective methods of promoting disability competence.

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.

Defining Underrepresented Minorities and Promoting Holistic Review Admission Strategies in Physical Therapist Education

Background and Purpose. Given the changing demographics of the United States, it is important for Doctor of Physical Therapy (DPT) education programs to address how best to recruit and retain students who will be able to provide culturally competent and sensitive care. Compared with the general population, the racial and ethnic diversity of professional membership in the American Physical Therapy Association and applications to and acceptance in professional physical therapist education programs has remained relatively static and does not mirror the diversity of the population at large. Position and Rationale. To best determine effective recruitment and retention strategies to address this shortfall in PT education, it is necessary to have (1) a unifying definition of underrepresented minorities (URMs) in physical therapy education and (2) an understanding of what is currently being done to promote a diverse student body. The American Council of Academic Physical Therapy empaneled its Diversity Task Force in January 2013 to address these two issues. This position paper reports on the efforts of the Diversity Task Force in developing a working definition of URMs in physical therapy education that reaches beyond traditional racial and ethnic descriptors, along with supporting information from a survey of entry-level DPT program directors on barriers to increasing diversity within the professional PT student population and strategies currently in place to overcome them. Discussion and Conclusion. Based on a uniform definition of URMs and the current status of recruitment/retention policies and practices designed to foster a diverse student population, we conclude that ongoing work is needed to increase diversity within DPT education and that utilization of a holistic application review process for admissions is one method to increase diversity.

Looking Outside Health Care to Teach Innovation in Physical Therapy Business Practice: Use of Harvard Business School Cases at Emory University

Background and Purpose. With profound changes in health care and the need for innovation to deliver exceptional value to patients receiving physical therapy, it is incumbent that students are prepared to look outside health care to adopt business practices from other industries and foster innovation as they begin to practice physical therapy. The purpose of this paper is to describe how the case-based analysis of Harvard Business School (HBS) cases from a variety of industries was implemented to teach business disciplines and promote innovative thinking in Doctor of Physical Therapy students at Emory University. Method/Model Description and Evaluation. The process for developing the course including course content and objectives, pedagogical, methods, student assessment including course evaluation and alumni survey at Emory University is described in this study. In addition, quantitative and qualitative analysis of students' course evaluation outcomes has been described in this paper. Outcomes. A total of 57 students participated in the elective course over the past 4 academic years. Class participation, written assignments, and quantitative analysis of course evaluations indicate that students agree the course objectives were met. Qualitative analysis of anonymous student comments revealed core themes of innovative course format and innovative learning, showing that the course instilled an innovation mindset in our students. Finally, 94% of course alumni survey respondents agreed that the course created an entrepreneurial and innovative mindset that impacted their practice of physical therapy. Discussion and Conclusion. We successfully introduced a course in a physical therapist education program to include training in innovation using HBS cases. To deliver exceptional value to patients receiving physical therapy, we must innovate. Thus, preparation of physical therapist practitioners who can innovate is critical to achieve our vision of optimizing movement to improve human experience and thereby transform society.

A National Survey on the Use of Immersive Simulation for Interprofessional Education in Physical Therapist Education Programs.

There is growing recognition that collaborative practice among healthcare professionals is associated with improved patient outcomes and enhanced team functioning, but development of collaborative practitioners requires interprofessional education (IPE). Immersive simulation, a clinically relevant experience that deeply engages the learner in realistic clinical environments, is used increasingly for IPE. The purpose of this study was to assess the use of immersive simulation as a strategy for IPE in physical therapist (PT) education programs. During fall 2014 and spring 2015, we contacted all 214 Commission on Accreditation in Physical Therapy Education accredited PT education programs in the United States and invited a faculty member to participate in our online survey. One hundred fourteen PT programs responded (53% response rate). Eighty responding programs (70%) identified themselves as users of immersive simulation, and 45 programs (39%) used simulation for IPE. Of these 45 programs, more than 90% included Interprofessional Education Collaborative competency learning objectives of roles/responsibilities, interprofessional communication, and teams/teamwork and 51% reported learning objectives for values/ethics for interprofessional practice. Interprofessional simulations with PT students commonly included nursing (91%). In programs using immersive simulation for IPE, 91% included debriefing and 51% included debriefing by interprofessional teams. Eighty accredited PT programs (70%) that responded to the survey use immersive simulation, and 45 programs (39%) use simulation for IPE. Most programs conduct simulations consistent with recognized best practice, including debriefing and Interprofessional Education Collaborative competency learning objectives for promoting interprofessional collaborative practice. We anticipate an increase in the use of immersive simulation for IPE as an educational strategy to comply with the revised Commission on Accreditation in Physical Therapy Education accreditation standards related to interprofessional collaborative practice that will become effective on January 1, 2018.

Counting the Dead: Who is Teaching Anatomy to Physical Therapy Students?

Background and Purpose. The purpose of this paper is to provide a summary of the history and current literature surrounding the use of unclaimed dead in anatomy education and to quantify the number, origin, and donation status of cadavers being used in teaching anatomy in physical therapist (PT) education programs. This data will support the need for anatomy educators in PT education programs to inform themselves and their students about willed body donation programs. Faculty should insist that every cadaver used in anatomy education in PT education programs has consented to be there. Participants. A list of accredited PT education programs was created (n = 217), and a survey was sent to each school for the anatomy educator to complete. Methods. An electronic survey was generated to collect number, sources, and origins of cadavers used in anatomy education in PT education programs. Descriptive statistics were used to report survey responses. Results. There were 99 responses (46% response rate), representing anatomy educators from 40 states. Anatomy educators reported during the past year they have taught PT anatomy alongside a total of 930 cadavers, and identified the sources of their cadavers: medical schools (52%); in house gift programs (24%); state anatomy boards (17%); private organizations (5%); a willed body program not attached to a medical school or in house (1%); and no source, as the program does not use cadavers (1%). Anatomy educators were asked if they knew the origin of the donors using the following definitions: (1) Registered donor: individual has consented to participate in anatomy education; (2) next of kin: family member has provided consent; (3) unclaimed dead: neither the individual nor a family member has provided consent. Discussion and Conclusions. Seventy-eight percent of anatomy educators reported knowing the origin of cadavers used to teach physical therapy anatomy, 10% reported not knowing, and 12% were uncertain. Anatomy educators reported that 72% (n = 670) of cadavers are registered donors, 3% (n = 30) are next of kin donations, and 0% (n = 0) are unclaimed dead. Anatomy educators were not able to categorize 25% (n = 230) of cadavers used during anatomy instruction in PT education programs. While the majority of PT education programs access cadavers via a medical school that has an anatomical gift program, some rely on state anatomy boards, private organizations, or on multiple sources. Most anatomy educators in PT education programs know the origin of the cadavers they use during instruction (78%), but some are uncertain. Anatomy educators report that their nonliving colleagues are mostly registered donors, and some are next of kin donations. No respondents report working with unclaimed dead. There is a difference of 230 cadavers (25%) who are not accounted for as registered, next of kin, or unclaimed. While these researchers recommend that direct consent be obtained from all of our nonliving colleagues, this could result in temporary donor shortages in anatomy laboratories. There is an immediate need for public education around the topic of whole body donation and increased involvement from anatomists in PT education programs in this process.

International “Broadening Experiences”: A Method for Integrating International Opportunities for Physical Therapist Students

BACKGROUND AND PURPOSEHealth care providers in the United States must be prepared to work with patients and clients from a wide variety of backgrounds, experiences, and places. Educators are charged with providing opportunities for students to develop skills such as cultural competence, social facility, cross-cultural understanding, and a wider word view-both figuratively and literally. Providing students with information about health professional education and practice around the world is also helpful. Opportunities for students to experience diversity should be available both inside and outside the classroom. International opportunities to learn about diversity, social determinants of health, physical therapist practice, and global health care can provide students with new ways of seeing the world. Such opportunities facilitate the growth and development of practitioners who have greater cultural awareness, global knowledge and understanding, knowledge of global health care issues, and knowledge of education and practice outside the United States. These future professionals will have a greater ability to relate to the wide variety of people they will encounter in their careers. Further, international opportunities often provide chances for professional networking and collaboration.Many physical therapist education programs are adding international opportunities1-4 In 2009, Pechak and Thompson4 examined the prominence and development of international opportunities in physical therapist education programs and found that nearly 43% of programs in the United States and Canada had international opportunities and that another 14% reported that such opportunities would be added in the near future. In that study, the faculty reported that international opportunities were beneficial for themselves and for students and that such opportunities enhanced the physical therapists' role in the global health arena. In the United States, this focus on international initiatives and the associated literature seems to be driven and supported by American Physical Therapy Association core values5 and by the accreditation standards of the Commission on Accreditation in Physical Therapy Education.6 Each of these documents includes the professional values of social responsibility, altruism, professionalism, and professional duty in practice and in the education of physical therapist students. These core values are closely connected to the cross-cultural and professional benefits of international experiences. The personal and professional value and importance of such experiences have been emphasized in the literature. International collaborations in academic and clinical settings have been found to result in global connectedness3 and rich and rewarding experiences that are life changing.7In physical therapist education programs across the United States, various models exist for providing international experiences for students. Aside from international clinical placements, other international programs include the use of service learning experiences; program-affiliated pro bono efforts, such as clinics; community partnerships for student exposure to various groups of patients/clients; and volunteerism.4,8 What is missing in the literature is a method for maximizing global opportunities for large groups of students without stretching already thin faculty resources.The general importance of providing international opportunities for students in higher education has been described by multiple authors.9-14 Rightly, the literature related to international experiences is often concerned with student outcomes. Although much of this research tends to be limited by small sample sizes, positive outcomes related to self-examination, intellectual growth and maturity, and skills in relationship and rapport building have been reported. These factors ultimately result in improved cultural competence after international experiences. International experiences have been reported to offer greater benefits in developing cultural competency skills than classroom education alone. …

HIV-Related Content in Physical Therapist Education Programs: A Curricular Needs Assessment

INTRODUCTIONOver the past 30 years, the development of antiretroviral therapy has drastically extended the life-span of people living with HIV (PLH). Because of this increased longevity, HIV is becoming a chronic disease; with proper treatment, PLH can have a life expectancy similar to that of their counterparts who are HIV negative.1 Therefore, the management of HIV has shifted to addressing the chronic systemic effects of the disease, such as musculoskeletal, neurological, and chronic pain issues. Mitigation of these effects requires a multidisciplinary approach to management of HIV-related impairments/, with an increasing role for physical therapists in the continuum of care for PLH.In an effort to enhance the use of physical therapy as part of the medical management of HIV, a 3-phase initiative was developed to analyze the current role of physical therapy in the HIV health care spectrum. Phase 1 assessed patterns of referral for physical therapist services made by physicians specializing in HIV management in Atlanta, Georgia, a city with a high prevalence of PLH. The results revealed that although most providers did refer their patients for physical therapist services, 30% of providers did not do so; the most commonly cited reasons were a lack of patient insurance, a denial of service by the clinics to which the patients were referred, and patient financial burdens.2 Phase 2 evaluated the knowledge and beliefs about HIV of 129 physical therapists practicing in the metropolitan Atlanta area. The results revealed that although most (65.1%) of the physical therapists surveyed reported their basic knowledge about HIV as advanced or competent, less than one-third of the respondents could correctly identify all methods of HIV transmission. Only half reported that learning best practices for treatments of HIV-related impairments was included in their physical therapist education.3On the basis of these results, this study (phase 3) was created to determine any potential gaps in HIV coverage in accredited physical therapist education programs throughout the United States. The aims of this study were to answer 3 questions: What percentage of physical therapist education programs cover HIV in their curricula? In what contexts is HIV covered (eg, pathophysiology, common physical therapy-treatable impairments, and interventions) in the programs surveyed? What needed teaching materials related to the inclusion of HIV are identified by surveyed faculty?REVIEW OF LITERATUREHuman immunodeficiency virus is a retrovirus that targets CD4+ T cells, reducing the human body's innate ability to fight off infections. The virus is spread through 4 specific bodily fluids (blood, semen, vaginal fluids, and breast milk). Seroconversion from HIV to AIDS occurs when the CD4+ cell count drops below 200/mm3, rendering a person more prone to opportunistic infections, such as tuberculosis, pneumonia, and lymphomas.4,5 In 2010, the Centers for Disease Control and Prevention estimated that in the United States alone, there were approximately 1.2 million PLH, and approximately 50,000 people continue to become infected with HIV each year.6,7 Because of the development of antiretroviral therapy for diminishing the immunosuppressive effects of HIV, the healthadjusted life expectancy-that is, the average number of years an individual is expected to live, with consideration of any disease or injury-has been extended for PLH.4,8-10A deterioration in physical function secondary to musculoskeletal, neurological, and cardiopulmonary impairments can be a consequence of chronic infection and systemic effects of antiretroviral therapy in PLH, leading to a significant decline in quality of life.11-13 These impairments fall within the scope of physical therapist practice. Musculoskeletal impairments secondary to deficits in bone remodeling and bone metabolism include myalgia, arthralgia, low back pain, osteoporosis, bone infection, and an increased risk for fractures. …

Student and Examiner Perceptions of an Innovative Model for Assessment of Neuromuscular Clinical Competence in a Professional Physical Therapist Education Program

Background and Purpose. Assessment of clinical skills is required in physical therapist (PT) education. It can be labor and cost intensive, and put significant demand on faculty time and resources. Currently there is no standard protocol for assessing clinical performance in the didactic portion of a physical therapy curriculum. The purposes of this study are to present an innovative model for assessment of the clinical competence of PT students managing patients with neurologic conditions that is time, labor, and cost effective, and to explore the perceptions of PT students and examiners relating to the innovative model. Participants. Seventy second-year PT students and 11 faculty/clinician examiners participated in this project. Methods/Model Description and Evaluation. A novel format for assessing clinical skills was developed and implemented over a 2-year period in a professional PT education program. Students acted as standardized patients and faculty/clinicians assessed 2 students performing the competency simultaneously. Perceptions of both PT students and examiners were explored using surveys. Data from the surveys were examined and presented. Total cost of the innovative model was calculated and compared to prior competency formats. Outcomes. Two cohorts of PT students and examiners completed the surveys. Student response rate ranged from 70% to 71%, and examiner response rate was 80%. Student responses were largely positive, particularly on questions relating to learning and stress reduction. Examiner responses were largely positive regarding the effectiveness of the innovative model. Significant cost and time reductions were achieved. The number of personnel hours was reduced to 36, representing a 50% reduction. Time was reduced by 50% and cost was reduced by 66%. Discussion and Conclusion. Students found the actor role beneficial to learning and to the development of empathy for future patients. Students being assessed found the experience less stressful, yet still felt that the competency effectively assessed their skills and clinical decision making. Examiners similarly found the innovative model of assessment of clinical skills effective. The reduction in time, cost, and labor demands could greatly benefit programs with large class sizes and small programs with fewer faculty. While satisfactory, this model warrants further development, and exploration of its validity for predicting success on clinical internships.

Exploring DPT Studentsʼ Perceptions of Team Function in a Collaborative Integrated Clinical Education Experience

Introduction. Integrated clinical education (ICE), defined as clinical learning experiences embedded within the didactic portion of a DPT curriculum, is an integral component of an overall clinical education curriculum. The collaborative supervisory model has been applied to ICE experiences in DPT curricula. Two physical therapist (PT) education programs developed similar ICE experiences incorporating the collaborative model as a component of their clinical education curricula. Benefits for student learning have been described in the literature for both of these models—in isolation, but not combined. The purpose of this study was to determine factors that students felt contributed to successful team function in a collaborative ICE experience. Review of Literature. ICE can provide opportunities for students to develop knowledge, skill, and professional behaviors in preparation for full-time and final clinical experiences. There is a great deal of literature that supports the collaborative model of clinical education to facilitate teamwork and collaboration, deeper level of critical thinking and problem solving, and enhanced clinical competence. Despite the benefits of including ICE in a DPT curriculum, as well as the benefits of the collaborative model of clinical education, the physical therapy literature does not describe factors leading to successful team function when these 2 models of CE are combined. Methods and Subjects. Subjects were 51 PT student teams (3 to 4 people each) from Duke University (2 cohorts) and the University of Colorado (1 cohort) who participated in a collaborative ICE experience. Following their first 2 weeks of ICE, student teams were instructed to create a mind map that depicted how their team functioned together in the clinic. Teams utilized an online mapping tool, “Coggle It,” to complete the mapping. The research team employed incident coding processes established in the literature to code the primary concepts of the team mind maps. Chi Square analysis was used to determine numeric differences across all codes among the 3 student team cohorts. Results. Twenty-four distinct codes were assigned to the primary concepts. Chi Square analysis revealed no significant differences between the 3 cohorts (P > .01) across all codes. More than 50% of teams indicated that “group dynamics” and “team communication” were vital to the effective functioning of their team in the clinic. More than 25% of the teams included “individual student qualities,” “the learning environment,” “practicing skills,” “the instructor's teaching strategies,” “adult learner characteristics,” and the “clinical instructor” of key importance. From the data, 4 themes emerged as being important for effective collaborative learning in an ICE: The Team, the Clinical Environment, the Individual Student, and the Clinical Instructor. Discussion and Conclusion. The 4 themes identified in this study contribute to the literature surrounding student learning in clinical education, specifically a collaborative ICE experience. This study suggests that these characteristics are important for positive experiences and should be factors that are considered by both academic programs and clinical instructors when designing, implementing, and teaching in a collaborative ICE experience.

PEDIATRIC EDUCATION SPECIAL SERIES: Assessment of Teaching and Learning Activities in Pediatric Physical Therapy: Factors Influencing Knowledge Development and Confidence

INTRODUCTIONFor nearly 100 years, physical therapist (PT) education programs have focused on preparing professionals for practice.1 The goal of these professional programs has been to provide high quality instructional activities that enable PT students to move from being unconsciously incompetent to becoming consciously competent professionals who are able to intentionally apply their knowledge and skills to effectively treat their patients.2-5 Bruno3 and Hunt and Furustig,4 in their confidence-based learning work, described this situation when they reported that learners who are highly confident, but possess low levels of knowledge, will often take actions that lead to negative outcomes. Alternatively, students who have high levels of knowledge, but lack confidence in their knowledge, may be reluctant to act in practice.3,4,6,7 Thus, the development of knowledge and knowledge confidence are essential aspects of competence, ones that PT students need to acquire as they prepare to enter the profession.Competence generally refers to the ability of someone to successfully complete a given task or demonstrate a specific skill.3,4,8,9 Recently, Rapport et al10 identified 5 essential core competencies around pediatrics that all PT students should attain in professional PT education. These competencies reflect a student's ability to successfully demonstrate knowledge, psychomotor skills, and other abilities such as self-confidence, interpersonal skills, clinical reasoning, and knowledge confidence, as related to human development, age-appropriate patient/client management, family-centered care for all patient/ client and family interactions, health promotion and safety, and understanding of legislation, policy, and systems. The focus of the current paper is on the teaching and learning activities that promote or inhibit the development of self-rated knowledge and knowledge confidence by PT students during a pediatric physical therapy course. Due to the limited amount of evidence that exists regarding the development of knowledge and knowledge confidence in pediatric PT education, the research questions for this study were: (1) Do the teaching and learning activities utilized in a pediatric physical therapy course result in an increase of students' self-rated knowledge and knowledge confidence regarding pediatric physical therapy? And, (2) which teaching and learning activities did students perceive as promoting or inhibiting the development of their self-rated knowledge and knowledge confidence in pediatric physical therapy content during this pediatric physical therapy course?Knowledge consists of the information, facts, and skills gained through education and experience.11 Knowledge confidence has been described and was operationally defined here as how certain someone is of their knowledge.12,13 Self-confidence has been defined as a general feeling of self-worth coupled with a belief in one's ability to handle certain situations or complete certain tasks, while a person's belief or confidence in being able to successfully execute a particular skill or behavior is known as self-efficacy.7,8,14-19 For example, to effectively assess a child's gait pattern, a therapist must understand concepts like step and stride length, initial contact, femoral anteversion, etc, then assess the child's range of motion and strength, interact effectively with the child and his/her family member(s), and confidently and accurately evaluate the presence or absence of critical events typical in gait. It is important to recognize that competence, confidence, and self-efficacy are closely related, but not synonymous.6 As noted above, students and practitioners with more confidence than knowledge may be dangerous in the clinic, while those with too little confidence in their knowledge and skills may not be willing to implement a given plan of care.3,4.6,7The development of competence in PT students occurs over time as a result of students who actively engage in their didactic education and clinical experiences. …

PEDIATRIC EDUCATION SPECIAL SERIES: A Course of Its Own: A Stand-Alone Pediatric Course Designed to Meet the Essential Core Competencies and Program Goals

Background and Purpose.Professional physical therapist (PT) education programs must prepare graduates to effectively provide physical therapy for patients throughout the lifespan. A number of models, standards, and competencies are available to guide the development of the pediatric curricular conte

Influence that Service in a Pro Bono Clinic has on a First Full-Time Physical Therapy Clinical Education Experience

Purpose: Physical therapist education programs strive to prepare their students for full-time clinical experiences in a variety of ways. Experiential and service learning in authentic contexts reportedly help students make connections between the classroom and the clinic. The purpose of this study was to explore the influences that service in a physical therapy pro bono clinic has on a first full-time clinical education experience. Methods: Participants were all third year doctoral physical therapy students at Widener University who were entering their first full-time clinical education experience. Sixteen participants kept journals throughout their first full-time clinical experience regarding the impact of their previous pro bono experience. Upon completion of the 10-week full-time clinical experience, the sixteen participants answered a Likert-scale survey to further delineate the influence of the pro bono experience, and fifteen of the participants participated in focus group discussions to further explore themes that emerged from the journal and survey data. Data from the focus group and journals were analyzed qualitatively. The responses from the surveys provided quantitative data. In addition, the researchers looked at the Clinical Instructors (CI) midterm comments on the APTA’s Clinical Performance Instrument (APTA PT CPI WEB) to further corroborate or disconfirm the findings. Results: Triangulation of the data points revealed 9 categories of positive impact that the pro bono experience had on their first full-time clinical experience. The strongest three categories in order were client interaction, clinical instructor interaction, and professional communication. The next five categories were of relative equal strength and related to specifics areas of competency. They were competency in documentation, evaluation, intervention, clinical reasoning and cultural competency. A final overarching category was increased confidence. CI comments on the midterm CPI corroborated these findings. Participants also shared ways in which the pro bono experience could have better prepared them for their full-time clinical experience. Conclusions: Regular participation in a pro bono clinic throughout the didactic portion of the physical therapy curriculum contributed to student confidence and competence in their first full-time clinical experience. Future research should include interviews with the clinical instructors to further corroborate the student perceptions. The findings of this study also serve to inform how the pro bono clinical experience can be enhanced to further contribute positively to the students’ first full-time clinical experiences.

Exploration of Relationships Among the Health Sciences Reasoning Test, the National Physical Therapy Licensing Examination, and Cognitive Admission Variables

Background and Purpose. Identifying variables that can predict success on the National Physical Therapy Examination (NPTE) and help determine who should be admitted to physical therapist education programs has been an area of interest for many years. The Graduate Record Examination (GRE) and the grade point average (GPA) have been found to correlate with the NPTE, but they explain less than 50% of the variance in performance. The purposes of this study were to determine whether there is a relationship between performance on the Health Sciences Reasoning Test (HSRT) and NPTE scores and to explore HSRT, GRE, and undergraduate GPA data for relationships that might enhance the admissions process. Methods. This study was a retrospective analysis of academic records of 4 cohorts. Results. A moderate bivariate correlation between the HSRT and the NPTE was identified, and a multivariable model in which the undergraduate GPA, the GPA at the end of the first year in a Doctor of Physical Therapy program, and GRE and HSRT scores were used to predict NPTE scores was demonstrated to improve model fit over that of a similar model without the HSRT. The models were used as the basis for creating an admissions decision tool. Discussion and Conclusion. Additional studies are required, but the HSRT may prove to be a valuable tool for predicting success in Doctor of Physical Therapy programs, especially for applicants whose GRE and undergraduate GPA scores are marginal.

Educating Physical Therapists in Women's Health: Recommendations for Professional (Entry-Level) and Postprofessional Curricula

Background and Purpose. Managing conditions unique to and more prevalent in women is an emerging trend in care. The key purposes of this study were to determine (1) practice patterns and emphasis of physical therapists, (2) how and to what extent physical therapists were educated about health, ( 3) curricular content deemed important in preparing practicing and professional (entry-level) physical therapists, and (4) by what means therapists may be interested in furthering their knowledge of health. Subjects and Methods. Subjects were a random sample (N = 1,021) of members of the Section on Women's Health of the American Physical Therapy Association who completed a survey on their practice emphasis, educational preparation in health, and opinions regarding content that should be taught at the professional and postprofessional levels in physical therapist education programs. Results. Thirty-seven percent of the subjects (n=347), representing 48 states, responded. A majority of respondents (n=204) reported that up to 25% of their practice involved treating specific issues and most had received minimal academic education specific to health. Examples of curricular content recommended for entry into the profession included osteoporosis, musculoskeletal conditions, obstetrics, and urogenital concerns, while pathology, pelvic floor assessment/treatment, endocrinology, and gynecology were recommended for the postprofessional level. Of the 347 who responded, practitioners' preference for postprofessional education was via continuing education (n=229) or certificate programs (n=227). Discussion and Conclusion. As physical therapist education program curricula evolve in response to degree advances and changes in care policy, educators can use this information to strengthen both professional and postprofessional curricula in health. Key Words: Women's health, Physical therapist education, Curriculum. INTRODUCTION Women's has become a national focus influencing everything from National Institutes of Health policy1 to nutrition options and vitamin supplements. Despite this interest, topics have been reported to be underrepresented in both professional and postprofessional physical therapist education programs.2,3 In 1979, Frahm wrote exposure to the OB/GYN area is noticeably sparse in the American physical therapy school curriculum.4 And now, over 25 years later, there is some question about the degree to which topics are being taught in physical therapist education programs today. According to A Normative Model of Physical Therapist Professional Education, professional physical therapist education programs should graduate students who are sensitive to individual and cultural differences when engaged in physical therapy practice, research, and education.5 To effectively compare the effects of sex on diagnosis, prognosis, health, and wellness, physical therapist education needs to expand the traditional medical view of women's health which typically includes reproductive issues in adolescent girls and adult women.6,7 Instead, physical therapist educators should take steps to account for the broad spectrum of concerns throughout the lifespan and the relative differences between men and women in terms of behaviors, morbidity, disability, and mortality. Additional considerations may also need to be made regarding the demographic, social, cultural, and political influences on a woman's and her approach to care.7-11 Unfortunately, there is little evidence on the current status of content in physical therapy curricula. Therefore, the current study was developed to address the following purposes: (1) to determine practice patterns and practice emphasis of a national sample of physical therapists, (2) to determine how and to what extent these physical therapists were educated about issues, (3) to identify important curricular topics in preparing both practicing (postprofessional) and professional (entry-level) physical therapists to address care needs unique to women, and (4) to determine whether, and by what means, physical therapists were interested in advancing their knowledge of health. …

Aneroid Blood Pressure Manometer Calibration Rates in Physical Therapy Curricula

Purpose: The purposes of this study were to (1) describe the calibration rates of aneroid blood pressure (BP) devices used in physical therapist (PT) education programs and (2) determine the validity of having the gauge needle resting within the zero-accuracy indicator as a proof of device calibration. Methods: We conducted a prospective descriptive study using a sample of convenience with an estimated 30-35 aneroid BP sphygmomanometers available for calibration check from each of the 6 PT education programs. Calibration of the measurement device used a certified mercury sphygmomanometer following the recommendations of the European Society of Hypertension. Descriptive statistics reported calibration rates, gauge needle position, device brand, cuff sizes, and whether the device was portable or wall mounted. Additionally, BP device calibration rates measured at universities that had or had not performed equipment calibration checks within the previous 2 years were compared using the Chi-square test with significance set at P ≤ .05. Results: Calibration failure was identified in 22.5% of 289 BP gauges, whereas 16.2% of devices with a gauge needle resting in the zero accuracy indicator failed calibration validity measures. Additionally, a significant difference between the calibration rates of equipment from universities that had (n = 47) and had not (n = 242) regularly performed calibration checks was identified (P = .001). Conclusion: This study found that 22.5% of aneroid BP devices used in the participating PT education programs were not in calibration. Additionally, visual confirmation of a gauge needle resting position falling within the zero accuracy indicator did not assure that a device was in calibration. Routine inspection of BP devices is imperative to assure that accurate BP readings are guiding clinical recommendations.