Physical Therapist Education Research Articles

Development of Domains of Competence and Competencies for Physical Therapist Education.

Competency-based education (CBE) has been gaining widespread acceptance as a viable method for transforming education within health professions. The purpose of this report is to describe the process we used to develop a set of domains of competence and associated competencies for physical therapists. The catalyst for this effort was our desire to implement CBE as part of the major renewal of our Doctor of Physical Therapy curriculum. We developed a draft set of domains and competencies for physical therapists by considering the future of physical therapy and relevant CBE literature. Next, we used a multistep survey-and-revise process to develop consensus on the appropriateness and clarity of each domain and competency. Surveys were repeated until an 85% threshold level of agreement was achieved for each domain and competency. Between rounds of the surveys, the Competency and Entrustment Writing Team reviewed feedback and edited items accordingly. The writing and feedback processes resulted in consensus on a total of 57 competencies, organized into 8 domains of competence. The development of defined outcomes for physical therapist education (PTE) through domains and competencies provides a framework for a broader effort to re-envision PTE. Careful attention to ensuring that the framework uses shared language across professions has the potential to enhance health care and the health of society.

Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study.

Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments. This study aims to identify the capabilities required to use TM in physiotherapy treatment. An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings. Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the "digital health technologies, systems, and policies" domain, 7 capabilities in the "clinical practice and application" domain, and 5 capabilities in the "data analysis and knowledge creation" domain. No capabilities were identified in the "system and technology implementation" domain. The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists.

Inter-rater Reliability of Pressure Pain Threshold Between Experienced and Novice Examiners: A Case Study of 2 Educational Approaches.

Pressure Pain Threshold (PPT) is used to objectively assess pain in clinical settings and is a recommended part of physical therapist education. An individual who is experienced in administering PPT will frequently train a student on the technique; however, optimal educational approaches for this instruction have not yet been identified. Therefore, the purpose of this case report is to describe 2 educational approaches (unstructured lecture and structured feedback with clinical relevance) in training 2 separate cohorts of Doctor of Physical Therapy students in PPT. The primary outcome of interest was the inter-rater reliability of PPT between an experienced and novice examiner. Cohort 1 (n = 37) received a traditional lecture approach consisting of watching a prerecorded video online, an in-person lecture with demonstration of the technique, and time to practice. Cohort 2 (n = 34) received the prerecorded video online and lecture with demonstration; however, key additions included a clinical relevance discussion along with structured peer-to-peer and instructor-to-student feedback using a competency-based checklist. PPT was assessed by each student (novice examiner) and one instructor (experienced examiner). Inter-rater reliability of PPT between a novice and experienced examiner was evaluated. Inter-rater reliability improved from poor/moderate (intraclass correlation coefficient low back = 0.46 [0.16-0.68], quadriceps = 0.54 [0.26-0.73]) to good (low back = 0.84 [0.67-0.92], quadriceps = 0.90 [0.79-0.95]) after the addition of structured feedback. Structured feedback from peers and instructors may be useful when learning PPT and improving inter-rater reliability, which has implications for training students within a laboratory or classroom. However, this case study would need to be replicated in an experimental design to examine the effects of varying types of feedback on learning outcomes.

Student physical therapists’ confidence in appraising and applying research after participating in a weekly journal club

Introduction: The objective of this study was to assess changes in student physical therapists’ confidence in their ability to critically appraise research and use research findings to inform their practice after completing a weekly journal club. Methods: Thirty-four students in a doctoral-level physical therapist education program completed a questionnaire before and after participating in a weekly journal club. The questionnaire asked students to rate their confidence in critically appraising research and using research to inform their practice. Results: Over the semester, there was significant improvement in students’ confidence in their ability to critically appraise research related to physical therapy practice and their confidence in using research to inform their practice. Conclusions: In general, it appears that a course-based weekly journal club can be effective for improving student physical therapists’ confidence in their ability to perform some of the key functions required for evidence-based practice.

Justice, Equity, Diversity, and Inclusion-Related Curricular Elements in Entry-Level Physical Therapist Education: A Delphi Study.

The purpose of this Delphi study was to determine whether experts in justice, equity, diversity, and inclusion (JEDI) in the field of physical therapy could achieve consensus on the key JEDI-related curricular content topics to be included in entry-level physical therapist education. Inequities exist at all levels of health care for historically underserved populations, including referrals, access, and quality of physical therapy services. The physical therapy field is facing challenges and opportunities in how to best prepare providers to address individual, community, and population health inequities. There is a lack of consensus in physical therapist education regarding essential curricular content related to justice, equity, diversity, inclusion, and antiracism. Eighty-four experts in JEDI in the physical therapy profession were invited through email to participate in the Delphi process. A Delphi survey brought together 39 identified experts in justice, equity, diversity, and inclusion within the field of physical therapy to reach consensus on key JEDI-related curricular topics in physical therapist education. In the first-round survey, participants answered an open-ended question: "What JEDI-related curricular content should be included in entry-level physical therapist education?" The work team coded these free-text responses to populate an initial list of curricular elements. Over 2 subsequent rounds of surveys, the experts came to a consensus on which curricular elements should be addressed within physical therapist education. Nineteen experts completed all survey rounds. In round I, coding of the expert group's responses generated 61 initial JEDI-related curricular elements. By round III, the group refined the list to 43 curricular elements; 41 of the 43 (95%) elements garnered 94% or higher consensus. The expert group deemed 30 of the elements "entry-level" content and 13 as more "advanced practice" topics. Experts had a strong consensus on key JEDI-related curricular elements that physical therapist education programs should include to best prepare providers to improve the health of society. Future scholarship will explore recommendations for how physical therapist education programs might prioritize and implement JEDI-related content.

Headache diagnosis and treatment: A pilot knowledge and needs assessment among physical therapists.

The objective of this pilot study was to assess physical therapists' (PTs) knowledge and needs regarding headache diagnosis and management. While there is significant research on physical therapy and cervicogenic headache, studies suggest that migraine is often under-recognized, misdiagnosed, and inadequately treated across society despite its high prevalence and burden. Because migraine commonly includes concurrent neck pain and/or vestibular symptoms, patients with migraine may present to PTs for treatment. Very little is known about PTs' headache and migraine education, knowledge, and clinical practices. A team of headache specialists and PTs adapted a previously used headache knowledge and needs assessment survey to help ascertain PTs' knowledge and needs regarding headache treatment. The cross-sectional survey was distributed online via Research Electronic Data Capture (REDCap) to PTs within a large healthcare system in Connecticut. An estimated 50.5% (101/200) of PTs invited to complete the survey did so. Only 37.6% (38/101) of respondents reported receiving any formal headache or migraine education in their professional training, leading to knowledge gaps in differentiating and responding to headache subtypes. Only 45.5% (46/101) were able to identify that migraine is characterized by greater pain intensity than tension-type headache, and 22.8% (23/101) reported not knowing the duration of untreated migraine. When asked about the aspects of care they believe their patients with headache would like to see improved, PTs reported education around prevention and appropriate medication use (61/100 [61.0%]), provider awareness of the degree of disability associated with migraine (51/100 [51.0%]), and diagnostics (47/100 [47.0%]). This sample of PTs from one healthcare system demonstrates knowledge gaps and variations in clinical practice for managing their patients with headache. Future research on integrating additional opportunities for headache education for physical therapists, including evidence-based behavioral therapies, is needed to ascertain whether it is likely to improve patient care.

Effect of the Collaborative Model on Communication and Clinical Reasoning in DPT Students’ Clinical Experiences

Introduction: The collaborative clinical experiences pair one physical therapist (PT) clinical instructor (CI) with one or more student(s) (Wolff-Burke et al, 2022).The collaborative model has been widely accepted among nursing and other healthcare professions. Benefits of the collaborative model include improved communication and clinical reasoning, enhanced teamwork, and reduced anxiety among students. Additionally, the collaborative model facilitates peer-to-peer learning and leadership. Despite the benefits, PT education has been slow to embrace this model. This study's purpose was to determine if the collaborative model is effective in helping students obtain the required performance ratings required by the university during their clinical experiences. Subjects included student placement records were reviewed to determine inclusion and exclusion based on participation in a collaborative experience between Spring 2022 and Spring 2023. Methods: Clinical Performance Inventory (CPI) data was obtained and analyzed in communication and clinical reasoning. The professionalism and academic tracking systems were also reviewed to obtain student history related to communication and clinical reasoning (CR). Demographic information on gender and age was also included for comparison. Results: Every student passed their clinical experience. Students scored higher than the expected threshold for their respective clinical experiences, with 76.3% over performing on communication and 85.5% on clinical reasoning. Female students scored higher than male students on communication and CR for the Integrated Clinical Experience (ICE). Students referred to the professionalism tracking system scored 3% lower on communication and 2% lower on CR compared to those who were not referred to the professional tracking system. Discussion: The collaborative model appears to be an effective supervision model for clinical experiences. It may provide an effective way for students to develop their communication and clinical reasoning skills. Future studies should be designed to compare students’ performance and perceptions between those in traditional and collaborative models.

Self-Efficacy of Physical Therapist Student Outcomes (SEPTSO): longitudinal responsiveness over a three-year curriculum.

Understanding the relationship between self-efficacy and academic and clinical education outcomes may improve professional physical therapist education. To document the longitudinal responsiveness of Self-Efficacy of Physical Therapist Student Outcomes (SEPTSO) scores from a single cohort throughout a three-year professional physical therapist curriculum and also to explore relationships between SEPTSO, grade point average (GPA), clinical education outcomes, and first-time pass rate on the National Physical Therapy Examination (NPTE). Thirty-five Doctor of Physical Therapy (DPT) students participated. The SEPTSO was administered electronically during semesters one and nine. The final GPA, Physical Therapist Manual for the Assessment of Clinical Skills (PT MACS), and NPTE outcomes were recorded. There was a significant increase in SEPTSO scores from semester 1 to 9 (t(16) = 34.55, p < .01, Cohen's d = 9.79, n = 17). In semester 1 (n = 35), there were no significant associations between SEPTSO scores and GPA (r = .011, p = .949), PT MACS outcomes (r = .092, p = .867), or first-time NPTE pass rate (rs = -0.088, p = .634). Longitudinal responsiveness of the SEPTSO in a three-year DPT curriculum was demonstrated. There were no associations between SEPTSO scores and other outcome measures.

Foot and Ankle Curricular Guidelines in Entry-Level Physical Therapist Education: How Are We Doing?

The Foot and Ankle Curricular Guidelines for Physical Therapist Professional Degree Programs (FACG) provided recommendations regarding essential entry-level content and skills. Eight years later, the extent of its implementation is unknown. This study characterizes entry-level Doctor of Physical Therapy (DPT) programs' foot and ankle curriculum with reference to the FACG. Curricular guidelines offer recommendations to professional degree programs striving for excellence. Review and revisions of guidelines are important to keep pace with and reflect evolving evidence and practice. One faculty member from 116 of 250 DPT programs participated (46.6% response rate). Participants were an average of 50.8 years old and taught a mean of 14.5 years. A cross-sectional 25-item online survey assessed foot and ankle contact hours, coverage of FACG recommended content, coverage of surgical procedures, and the use of FACG for curricular assessment, modification, and development. Foot and ankle content was covered in physical therapy curriculum for a mean of 48.2 hours (range 12-120 hours). Eleven of the 25 recommended diagnoses, 29 of the 49 examination skills, 6 of the 7 intervention skills, and 3 of the 14 surgical procedures were covered by most (≥90%) of the programs. Reported use of FACG for curricular processes averaged 50.1-51.5 (0-100 numerical scale). Across a wide range of contact hours, coverage of FACG recommended content was approximately 57% (46/81 recommended elements in ≥90% of programs). Although not specifically recommended by FACG, surgical procedures were less commonly covered by programs. Study findings question FACG implementation and may reflect differences across programs in depth and breadth of content. Identified curricular gaps may warrant addressing in future guidelines.

Beyond bones, joints and muscles: can physiotherapists have a role in identifying and supporting domestic violence victims?

Purpose Domestic violence (DV) is a pervasive global issue affecting people across all demographics. Physiotherapists, due to their close patient contact, may be ideally positioned to identify and support victims. However, their preparedness for this role is shown to fall short of needs via a study that aimed to determine physiotherapists’ knowledge, attitudes, and experiences with DV in Estonia, Greece, Cyprus, and Spain. Methods An online questionnaire via the LimeSurvey® platform assessed the experiences of 167 physiotherapists across the four countries. The survey covered respondent demographics, training received on DV identification and referral procedures, self-reported confidence in identifying and referring DV victims, and the frequency of encountering suspected cases. Results The findings revealed a substantial gap between the legal mandates for healthcare professionals to address DV (as outlined in the Istanbul Convention and a 2024 EU Directive) and the preparedness of physiotherapists. Only 13.2% of respondents had received any DV training, and less than half felt confident making referrals to support services. However, there is an evident association between experience and awareness – physiotherapists with more years of experience, particularly those specialising in paediatrics or chronic conditions, are more likely to have encountered and reported suspected DV cases. Conclusions The study’s generalisability may be limited due to the sample size and the selection process (social media outreach and professional networks). Additionally, self-reported data can be prone to bias. Nonetheless, these findings highlight a critical need for integrating DV training modules into physiotherapy education curricula, both at the entry-level and throughout continuing education programs. The Online Professional Education for Physiotherapists and other healthcare professionals on DV (OPEP) project, in response to this gap, has developed a comprehensive online training resource specifically for physiotherapists on DV identification and referral protocols. This initiative aligns with the growing recognition of healthcare professionals’ role in combating DV and can play a vital role in supporting victims and survivors.

Meeting the Health Needs of Society Through Curricular Innovation in Physical Therapist Education: Examples From 3 Entry-Level Programs.

Entry-level physical therapist (PT) education programs play a critical role in inspiring future leaders to become moral change agents, capable of understanding and addressing evolving societal health needs. Social reconstructionism represents an educational philosophy focused on alleviating pervasive inequities and improving the health of society; however, its application in PT education is not well understood. The purpose of this article is to describe the approach 3 entry-level PT programs used to manifest social reconstructionism within their curricula to foster social consciousness and strengthen moral agency. The Framework for Educating Health Professionals to Address the Social Determinants of Health informed the development of a conceptual framework that illustrates the role of PT education programs in creating transformative learning environments and preparing learners to meet societal health needs. Concepts within this framework were operationalized according to 5 domains put forth by Jensen et al. and related competencies put forth by the Association of American Medical Colleges. Narratives from each program demonstrate how the design and implementation of curricula, grounded in social reconstructionism, can be accomplished through 1) ongoing modifications, 2) thoughtful reconstruction, and 3) initial design. Sample learning activities, objectives, and assessment strategies are provided. The proposed method was effective in guiding meaningful objectives, learning activities, and assessment strategies grounded in social reconstructionism. Such findings can inform the design of curricula that inspire the next generation of transformative leaders who work to alleviate pervasive inequities and improve the health of society.

A Brief but Spectacular Take: Reflecting on Professionalism by Student Physical Therapists.

Professionalism is an abstract concept that requires reflection for students to generate personal meaning and application. It should be taught explicitly within the academic part of a professional physical therapist education program. The purpose of this case report was to present one unique strategy to increase reflection about professionalism. Forty-four students enrolled in the first semester of a professional physical therapist education program participated in the case report. All were enrolled in a 1-credit hour course, Professional Issues, in which they developed a 2- to 3-minute video presenting their brief but spectacular take on various professional issues. Students responded in an online discussion tool to 2 of their colleagues' videos, developing a rich conversation. An optional 11-item survey about student satisfaction with the assignment was distributed electronically. A 4-point Likert scale was used for 10 items with the 11 being open ended. An analysis of the video presentations identified 4 themes: diversity, equity, and inclusion; self-care; core values; and patient management. Discussions were positive, professional, and encouraging. The optional survey had a 45% response rate. The medians for individual items ranged from 3 (6 items) to 4 (3 items). Reflection is essential to provide meaning in the learning process. Creating a video reflection that allowed students to describe their passion for the profession and then to discuss it in an online format was a unique teaching/learning activity. The concept of professionalism was successfully explored using the assignment that was well-received, and most students found it beneficial to their personal growth.

How Integrating the 5 Pillars of Community Practice Can Transform Physical Therapist Education and Reduce Health Disparities.

Patient history assists clinicians in determining the most appropriate tests to identify the symptoms' source and select appropriate interventions. Therefore, a subjective history is an essential component of patient management. When physical therapist practitioners transition into academia, they must understand how the history of the education system may affect learners. Health disparities are related to the lack of workforce diversity and skills in cultural responsiveness, and the education system is critical in addressing the impact of future providers on health disparities. Developing a doctor of physical therapy program to address health disparities requires an analysis of the historical context of the US educational and health care systems, along with traditional components of physical therapist education. This country's education system was built upon a 2-tiered system, where minoritized individuals struggled to overcome barriers imposed by legislation and societal beliefs. Jim Crow laws continued this unequal access to education, and the recent Supreme Court ruling to deny race-based affirmative action continues these inequities. This historical context informed the construction of the College of Saint Mary Doctor of Physical Therapy Program. The program's mission led to using less traditional educational approaches; thus, the pillars of practice took form. The 5 pillars evolved to include social determinants, inclusive faculty and student recruitment and retention practices, equitable grading, culturally responsive pedagogy, and community development. The purpose of this paper is to present a historical overview of the US education system and its influence on physical therapist education. Furthermore, it will illustrate how this historical context inspired the 5 Pillars of Community Practice from College of Saint Mary and discuss the challenges and interventions related to these pillars. There are tremendous disparities in educational outcomes and patient services in the United States. Disparities are most significant in those with historically marginalized identities. If those disparities are to improve, a change is required in the people providing care to patients. The best way to accomplish this is by transforming how future providers are educated.

A Community Development Approach in Physical Therapist Education.

A large part of one's health is directly related to where one lives. Physical therapists and physical therapist assistants can play a vital role in improving the health of society by engaging in their local communities through community development. Community development is a practice where community members and outside stakeholders, such as physical therapists, come together to meet the needs of a community.

Equitable Grading Practices in Physical Therapist Education: A Case Report.

To optimize learning in physical therapist education, learners need opportunities to grow from their unique starting points. Traditional grading practices like A to F grades, zero grades, and grading on timeliness and professionalism hinder content mastery and accurate competency assessment. Grading should focus on mastery of skill and content, using summative assessments for final grades, a no-zero policy, and actionable feedback. Equitable grading supports learners from all backgrounds and identities and promotes academic success. This case study provides guidance and recommendations for implementing equitable grading practices in academic physical therapist programs. Over a 2-year period, a doctor of physical therapy program began implementing 5 strategies to create more equitable grading practices: (1) eliminating zero grades, (2) allowing late assignment submissions without penalty, (3) using low-stakes formative assessments throughout the semester, (4) weighing end-of-course assessments more heavily than initial ones, and (5) offering a no-stakes anatomy prep course before matriculation. Outcomes from implementing equitable grading practices varied. Some learners felt increased stress from fewer points opportunities, while others appreciated the reduced anxiety from low-stakes assessments. Some saw multiple attempts for peers as unfair. Faculty faced higher workloads due to detailed feedback and remediation but believed it benefited learners. Median final grades improved in some courses, remained stable in others, and slightly decreased in one. Overall, the changes had minimal impact on most learners' grades but significantly improved outcomes and retention for struggling learners. This case report documents the implementation of equitable grading practices in a Doctor of Physical Therapy program, offering valuable insights and recommendations for other institutions aiming to adopt similar practices. Inequity in assessment widens the gap between learners entering professional programs. Equitable assessment practices level the playing field, enabling learners from diverse backgrounds and identities to succeed. Increased diversity benefits everyone, especially patients, by reducing health disparities for historically marginalized groups.

Using Simulation-Based Mastery Learning to Achieve Excellent Learning Outcomes in Physical Therapist Education.

The 2 aims of this observational study are (a) to describe the implementation and feasibility of a bed mobility skills simulation-based mastery learning (SBML) curricular module for physical therapist students and (b) to measure learning outcomes and student perceptions of this module. Simulation-based mastery learning is an outcome-based educational approach that has been successful in other health professions but has not been explored in physical therapy education. Eighty-seven students in a single cohort of a Doctor of Physical Therapy program. The SBML module in this pretest-posttest study included a pretest, instruction, initial posttest, and additional rounds of instruction and assessment as needed for all learners to achieve the minimum passing standard (MPS) set using the Mastery Angoff and Patient Safety methods. Outcome measures were bed mobility assessment pass rates and scores, additional student and faculty time compared with a traditional approach, and student perceptions of their self-confidence and the module. All students achieved the MPS after 3 rounds of training and assessment beyond the initial posttest. Mean Total Scores improved from 67.6% (12.9%) at pretest to 91.4% (4.8%) at mastery posttest (P < .001, Cohen's d = 1.8, 95% CI [1.4-2.1]); mean Safety Scores improved from 75.2% (16.0%) at pretest to 100.0% (0.0%) at mastery posttest (P < .001, Cohen's d = 1.5, 95% CI [1.2-1.9]). Students who did not achieve the MPS at the initial posttest (n = 30) required a mean of 1.2 hours for additional instruction and assessment. Survey results revealed an increase in student confidence (P < .001) and positive student perceptions of the module. Implementation of this SBML module was feasible and resulted in uniformly high levels of bed mobility skill acquisition. Based on rigorous learning outcomes, feasible requirements for implementation, and increased student confidence, SBML offers a promising approach for wider implementation in physical therapy education.

Web Site Accessibility Among Doctor of Physical Therapy Programs in the United States.

Given the impetus to improve accessibility for diverse learners seeking physical therapist education, it is critical that all entry points to access information have minimal barriers. This study identified Web site accessibility barriers among Doctor of Physical Therapy (DPT) programs in the United States. Web site accessibility has been evaluated among many institutions of higher education, but none focused on DPT education. Individuals with disabilities may be adversely affected by Web site accessibility barriers. This cross-sectional study included 262 DPT programs in the United States. Doctor of Physical Therapy program characteristics collected were geographic region, institutional control type (public/private), medical school affiliation, accreditation status, total institutional enrollment, and DPT class size. The Web Accessibility Evaluation (WAVE) Tool assessed data related to accessibility barriers among DPT program homepage Uniform Resource Locators. Three primary outcomes from the WAVE Tool included WAVE Total Errors, Error Density, and Total Alerts. Web site homepage accessibility barriers varied among programs for WAVE Total Errors (range 0-150), Error Density (range 0-14.6%), and Total Alerts (range 1-331). Median Total Errors were greater among private (9.0) versus public (5.0) institution Web sites (P < .001). Median Total Errors were greater among those institutions not affiliated with a medical school (9.0) compared with those that had an affiliated medical school (7.0) (P = .04). No differences in accessibility barriers were identified according to geographic region or accreditation status (P > .05). Median Total Errors were significantly different between institutional enrollment quartiles (H[3] = 17.9, P < .001), with no differences noted between DPT class size quartiles for any outcome (P > .05). Generally, weak-fair inverse correlations were observed between student enrollment for the institution and Web site accessibility barrier outcomes. Homepage accessibility barriers varied greatly among DPT programs in the United States. Factors, including being a private institution, no medical school affiliation, and lower institutional enrollment, were related to increased accessibility barriers.

A Novel Approach to Safe Patient Handling and Mobility Training in Physical Therapist Education

Background: Safe patient handling and mobility (SPHM) training is prevalent in health care education and practice. However, there is limited evidence of this training in physical therapist education programs. Purpose: To determine if a single training session with a mobile laboratory equipped with SPHM equipment increases the knowledge of SPHM principles and techniques and is valuable to students prior to their first clinical experience. Methods: Training included a 1-hour lecture on SPHM principles, research, and techniques, followed by two 50-minute SPHM practice stations. One session was conducted using a mobile laboratory. Students completed a pretest/posttest measuring knowledge of SPHM principles. Students completed a survey regarding the perception and placement of SPHM training within the curriculum. Results: A total of 129 students in a physical therapist education program were invited to participate; 59 from first-year cohorts and 70 from second- and third-year cohorts. Eighty-seven students volunteered to participate, including all 59 students from the first-year cohorts receiving training as the experimental group, and 28 from the other cohorts receiving no training as the control group. Seventy students met the criteria for survey data analysis; 42 experimental and 28 control. Of those who received training, 90.5% reported that SPHM training improved their confidence prior to their inpatient clinical experience; 85.5% in the control group would have felt more confident being placed in an inpatient facility if they received SPHM training, and 85.7% of the experimental group and 89.3% of controls agreed that SPHM training should be performed prior to the first clinical experience. A paired t test showed that first-year students reported a statistically significant increase in knowledge of SPHM principles (P &lt; .001). Conclusions: Physical therapist education programs should consider SPHM training prior to students’ first clinical experience to increase student confidence in inpatient settings.

Melanoma and People of Color: The Role of Physical Therapists

While the incidence of melanoma in people of color is low, when melanoma is diagnosed, it is often at later stages, resulting in the likelihood of death when compared to non-Hispanic White individuals. This is a health disparity that needs to be addressed. This disparity demands the attention of first-line health care providers, especially providers serving minority populations. Physical therapists (PTs) in the United States are allowed direct access to patients (access specifics vary by state) and are well-positioned to be part of the solution to this health disparity. The skin is an organ highly accessible to and frequently encountered by PTs, and early detection is associated with better melanoma-related outcomes. However, there is limited literature available regarding PTs and their role in aiding melanoma detection in skin, much less among people of color. This perspective paper introduces a novel, inclusive screening approach, following the mnemonic NO SUN, as an adjunct to the well-established asymmetry, borders, color, diameter, and evolution/evolving rule to address the disparity. The mnemonic NO SUN stands for Non-sun-exposed, Oral, Soles and palms, Underneath genitalia, and Nail beds—areas where suspicious lesions are commonly found in people of color. Both patient and PT education on melanoma and how its presentation differs in people of color are included in this strategy. Highlighting the needs of this special population and addressing those needs with standard physical therapy practice serves as a path toward health equity within an interdisciplinary framework.

Changes in rehabilitation students’ clinical placement and clinical competence at graduation during the COVID-19 pandemic: A pilot study

BACKGROUND: The COVID-19 pandemic has affected physical and occupational therapist education in various ways. OBJECTIVE: This study investigated whether the pandemic changed clinical placement, thus influencing the clinical competence of physical and occupational therapists at a hospital in Japan. METHODS: Eleven therapists (seven physical and four occupational) participated in this study in April 2021. Clinical placement teaching methods were surveyed using an online questionnaire. The Objective Structured Clinical Examination (OSCE), comprising attitudinal and technical items, was used to examine clinical competence. The results were calculated as the sum of the attitudinal and technical scores, and the ratios of these scores to the full score were compared using a paired-sample Wilcoxon signed-rank test. RESULTS: During the pandemic, some schools implemented shortened practical clinical placements. The substituted classes included online-only classes and combined online and face-to-face classes. Regarding clinical competence, scores on the OSCE were mostly high. The median proportion of the total attitudinal score to the perfect score was 100% for all three items (range-of-motion test, muscle strength test, Stroke Impairment Assessment Set). The median proportion of the total technical score to the perfect score ranged from 56.7% to 76.7% for the three items. The ratio of the total attitudinal score to the full score was significantly higher than that of the total technical score to the full score (p = 0.001). CONCLUSIONS: Most clinical placements were canceled or partially administered through online learning during the pandemic. This decrease in clinical placements did not affect newly recruited physical and occupational therapists’ clinical competence.