Physical Therapist Education Research Articles

An Interprofessional Geriatric Experiential Learning Experience: Its Impact on Physical and Occupational Therapist Students

Introduction. Accreditation standards for physical therapist (PT) education require the inclusion of interprofessional education (IPE) in order to prepare health care professionals to work in collaborative environments. Additional guidelines document the need to educate PT students in the care of older adults; however, a gap in readiness for entry-level practice exists. Therefore, there were three purposes of this study that were to 1) examine the impact of an IPE experiential learning project on PT and occupational therapist (OT) students' knowledge and attitudes toward each other's professions, 2) examine students' comfort, value, and ability to work with another profession, and 3) assess the project's impact on PT and OT students' attitudes toward older adults. Methods. Physical therapist and OT student groups, under the supervision of faculty, evaluated a community dwelling older adult over 3 visits and developed a comprehensive wellness program, which was provided by the students on visit 4. Students completed 2 surveys: the Interprofessional Socialization and Valuing Scale (ISVS) and Kogan's Attitude Towards Old People Scale (KAOP), prior to and at the conclusion of the project. Results. The Wilcoxon’s signed rank test showed significant increases after the completion of the IPE project in the total ISVS (P < .001) median scale scores for all students and on the subscales regarding the ability (P < .001), value (P < .001), and comfort (P < .001) in working with others. Significant increases were observed for all students on the total KAOP scale scores (P < .001) and the positive subscale scores (P < .001); significant decreases were observed in the negative subscale scores (P < .001). Discussion and Conclusion. This study demonstrates a successful IPE experiential learning project used to enhance PT and OT students' abilities, values, and comfort with collaborative practice and enhancement of PT and OT student groups' attitudes toward older adults.

Physical therapists with work-related musculoskeletal disorders in the State of Kuwait: A comparison across countries and health care professions.

In the US, as the demands for rehabilitation services increase, work-related musculoskeletal disorders (WMSDs) have increased among rehabilitation practitioners. This trend has been noticed among physical therapists (PTs) in the State of Kuwait. The purpose of this study was to determine the prevalence and risk factors associated with WMSDs among PTs in Kuwait over a 12-month period. In addition, the result compared across countries and health care professions. A descriptive cross-sectional design was used in this study. A self-administered questionnaire was distributed to the PT departments at Kuwait government hospitals and schools. A total of 312 returned questionnaires (69.3% response rate) were received. Results showed that 149 (48%) PT respondents experienced WMSDs. The lower back and muscle spasm were the most common area of the body injured and type of injury, respectively. Manual therapy techniques and patient transfers were most common activities associated with injuries. The prevalence of PTs with WMSDs in Kuwait was high and similar to other studies of PTs with WMSDs working in other countries. The performance of work activities was the leading risk factor for WMSDs, and WMSDs were prevalent among industrialized, industrially developing, and underdeveloped countries. Education of PTs regarding ergonomic and biomechanical principles as well as hands-on training of patient handling are the key tools to help prevent WMSDs.

Integration of Safe Patient Handling and Mobility Principles in Professional Physical Therapist Education: A Case Report

Background and Purpose. Safe patient handling and mobility (SPHM) programs are being used across the country to safely transport and mobilize patients while at the same time reducing injury risk to caregivers, including physical therapists (PT) and physical therapist assistants (PTA). The American Physical Therapy Association has called PTs and PTAs to not only use the concepts of SPHM in clinical practice, but also be leaders in utilization, development, and implementation of SPHM programs, including training and education of other health care team members. Perlow, et al have recommended that SPHM content be integrated into Doctor of Physical Therapy (DPT) education. This case report outlines 1 current module used to deliver such content. Case Description. A neurologic interventions course within the DPT curriculum was selected using a framework that linked content, objectives, and learning activities with relevant Normative Model criteria and Physical Therapist Code of Ethics to improve student self-efficacy with SPHM content. Primary goals were to improve student awareness about risk and impact of work-related musculoskeletal disorders, expose students to the expected role of the PT as an advocate for and educator in SPHM programs, and provide hands-on experience with SPHM technologies. The 6-hour session was completed in 1 day with a 1-hour lecture and 5 hours with a variety of hands-on activities. Outcomes. Student learning was assessed through a pre–post class questionnaire, documentation/discussion of experiences, and presentations of student-generated neurologic interventions using SPHM equipment. Awareness of increased risk of injury, limits of 'good' body mechanics, and feasibility of using SPHM technologies to improve the quality of physical therapy practice dramatically increased. Discussion. Students should participate in a variety of learning activities threaded through the curriculum to provide sufficient hands-on opportunities to improve self-efficacy in using SPHM principles in rehabilitation. By developing a basic level of competency with SPHM principles, students may be more likely to adopt SPHM as a professional value once graduated. Improvements to this model, recommendations for SPHM integration into DPT curricula, and research opportunities are discussed. Conclusion. We have provided 1 model that embeds SPHM content into entry-level physical therapist education. In doing so, educators are advancing physical therapy skills needed to apply evidenced-based therapeutic principles in difficult to move patients while reducing risk of injury to students and new graduates of the profession.

The Development and Implementation of a Faculty Development Residency Within Physical Therapist Education

Background. Over the past decade, there has been a significant proliferation of physical therapist (PT) programs within the United States. Along with these more accredited PT programs come vacant faculty positions and the need for well qualified candidates to fill core faculty rolls. The Faculty Residency Ad Hoc Group (FRAHG) of the American Board of Physical Therapy Residency and Fellowship Education was established to discuss the growing demand for qualified faculty within PT programs. A faculty development residency (FDR) was created based on the work of the FRAHG. Method. A 2-year full-time FDR was established at Duke University Doctor of Physical Therapy (DPT) Program. The program consists of didactic modules covering various facets of academia, teaching responsibilities, mentorship, and scholarly projects. The 2-year progressive curriculum builds on foundational knowledge and skillsets in order to move toward greater independence as a faculty member. Discussion. The FDR within the Duke DPT program has demonstrated the ability to identify and foster the knowledge and skills deemed valuable from the perspective of the residency directors, core faculty members, learners, and the residents themselves. Conclusion. Moving forward, the FDR appears to be a viable and meaningful option for the increasing demand for well-prepared core faculty within a DPT program. The model proposed has successfully led to the prior residents' ability to be competitive and successfully secure faculty positions upon completion.

Effect of Motor Learning Theory-Assisted Instruction Versus Traditional Demonstration on Student Learning of Spinal Joint Manipulation

PurposeA high-velocity low-amplitude thrust joint manipulation (HVLAT) is an intervention used by clinicians to treat spine pain. HVLAT is an entry-level skill included in the curriculum of physical therapist education programs. The objective of this study was to investigate the effects of utilizing a motor learning theory assisted teaching strategy on physical therapy student HVLAT confidence and skill acquisition as compared to a traditional lab. MethodThirty physical therapy students were divided into two groups. One group received a traditional lab. The other group received a lab involving sequential partial task practice (SPTP) strategy in which students engaged in partial task practice over several repetitions with different partners. Student confidence and skill acquisition was determined through comparison of pretest and posttest surveys and performance on skills assessments. ResultsThe traditional lab and SPTP lab groups demonstrated similar response from pretest to posttest related to their HVLAT confidence. Student grades on their skills assessment measuring skill acquisition showed no significant differences between the lab groups. DiscussionThe findings suggest that the SPTP lab strategy was as effective as a traditional lab structure for developing physical therapy student HVLAT confidence and skill acquisition. The majority of students in both lab groups reached a level of confidence that allowed them to feel comfortable teaching someone else these HVLAT skills. It is up to the instructors involved in delivering HVLAT content in physical therapist education programs to determine what learning activities are best suited to meet their specific objectives.

The Integration of TeamSTEPPS Into Interprofessional Education Curricula at 3 Academic Health Centers

Background and Purpose. The need for developing collaborative practice–ready health care providers, along with new interprofessional education (IPE) accreditation standards, highlights the importance of IPE in physical therapist education curriculum. As we strive to meet the goal of preparing students for collaborative practice and team-based care, the TeamSTEPPS system can be integrated into IPE programs to assist in the provision of quality health care and in the prevention of medical errors. Emory University (Emory), Kansas University Medical Center (KUMC), and the Medical University of South Carolina (MUSC) have integrated TeamSTEPPS into their IP classroom- and practice-based curricula. The purpose of this paper is to describe how these academic health centers have embedded TeamSTEPPS into their IP curricula, with the goal of assisting academic and clinical faculty with the development and implementation of learning activities directed toward the development of IP competency. Method/Model Description and Evaluation, Outcomes. The IPE models used by Emory, KUMC, and MUSC use the TeamSTEPPS framework and are described with select evaluation measures and outcomes. The Emory and KUMC models are primarily classroom based, whereas the MUSC uses a combined classroom- and clinic-based model. Although each institution's model for IP training and assessment is different, all have shown positive results. Discussion and Conclusion. With new IPE accreditation standards for most health professions programs, using TeamSTEPPS is a strategy to assist in meeting the standards for IPE training and a larger goal of improving the quality and safety of patient care.

Physical Therapist Education and the Labor Market in Brazil: Advances and Challenges.

In Brazil, the number of physical therapy education programs and, consequently, of professionals has been growing for the past 20 years. The objective of the study was to describe the evolution and distribution of physical therapist education programs in Brazil and to analyze the impact of workforce growth on the labor market for these professionals. This was a descriptive, exploratory, quantitative study. Secondary data collected from official sources in Brazil were used. The first physical therapist education program was created in 1958, and, after significant growth, 536 programs were active in 2014. The historical series (1996-2014) shows a corresponding increase in the number of admissions by higher educational institutions. This expansion resulted in an increase in the number of professionals, with an impact on the labor market. The workforce in physical therapy is predominantly female, and women increased their participation in this labor market from 59% in 1996 to 81% in 2014. An increase in nominal monthly salaries was observed over the years from US $797.00 in 1996 to US $1056.00 in 2014. Nevertheless, the real average salaries, that is, salaries adjusted to inflation, have followed a trend of devaluation. Results of this study must be interpreted in terms of overall trends rather than as precise absolute numbers due to the inherent nature of the varied secondary data sources. These data can support further discussion on training and the labor market in the field of physical therapy.

Factors That Predict Institutional Adoption of Professional Physical Therapist Education Programs.

Between 1995 and 2015, the number of accredited physical therapist education programs in the United States rose from 127 to 224. Colleges and universities have been known to develop new programs in an effort to generate revenues through student tuition. In the present study, sources of institutional revenue and expenditures were used as predictors for the adoption of physical therapist education programs. Yearly data from the Integrated Postsecondary Education Data System for 1731 higher education institutions were combined with dates from the Commission on Accreditation in Physical Therapy Education for physical therapist education program accreditation from 1995 to 2015. A retrospective event history analysis of yearly institutional data was used to calculate the hazard of an institution adopting a physical therapist education program on the basis of institutional revenues and expenditures. Private institutions were 62% less likely to adopt a physical therapist education program when they experienced a 1% increase in total revenue per full-time-equivalent student. Conversely, a given private institution was 2.71 times more likely to adopt a physical therapist education program for every 1% increase in total expenditures per full-time-equivalent student. Both public and private institutions experienced an increased chance of adopting an entry-level (professional) physical therapist education program when instructional expenditures rose. They were also more than twice as likely to adopt physical therapist education programs when they experienced a 1% increase in the number of students. Causation between professional physical therapist education program adoption and the variables studied cannot be determined through observational analysis alone. The more revenue a private institution generated, the less likely it was to add a program in the search for further revenues. As expenses rose, the chance of adoption trended upward beyond increases in institutional revenues for both public and private not-for-profit institutions.

Scope of practice of haemophilia physiotherapists: A European survey.

European guidelines on the care of haemophilia recommend ready access to a range of services provided by a multidisciplinary team of specialists including physiotherapy. However, the scope of physiotherapy provided is unknown. The Physiotherapists Committee of the European Association for Haemophilia and Allied Disorders (EAHAD) conducted a web-based survey to quantify the role and scope of practice of physiotherapists involved in haemophilia care. The survey was sent to more than 200 physiotherapists registered on the EAHAD database. Questions concerned their work practices including assessment and treatment activities and level of autonomy. Eighty physiotherapists from twenty-four European countries responded. Considerable heterogeneity exists in roles, responsibilities, and clinical practice of physiotherapists, particularly in access to and type of physiotherapy treatment provided, as well as the skill set and autonomy of physiotherapists to make independent assessment and treatment decisions. This pan-European survey establishes a context to support physiotherapy role development and professional identity. Key recommendations include the following: (a) establishing a pan-European network to support collaboration and education for physiotherapists working in haemophilia, (b) developing a core skills and capability framework to ensure person-centred approaches are central as well as working in partnership with those with the condition to maximize early recovery, support self-management and enablement in remaining active and independent, (c) regular training, standardized validation and maintenance of competency for assessment tools, (d) well-designed randomized clinical studies with larger numbers of participants from multiple sites should be the focus of future research.

Characteristics of Entry-Level Physical Therapist Education Program Directors

Introduction. Development of academic leadership remains a long-standing topic of research and discussion. Specific to physical therapist education, the annual turnover of program directors (PDs) and the proliferation of new entry-level programs prompt further investigation of the responsibilities, characteristics, and leadership competencies needed for current PDs, which can inform optimal development opportunities for future PDs. Review of Literature. Previous studies, conducted when entry-level physical therapist education culminated in a master's degree, demonstrated that the primary role of a PD was to act as a faculty advocate to higher administration. There is limited literature directly related to the work, preparedness, development, challenges, and job satisfaction of PDs, and no data exist about a possible shift in roles and responsibilities since the advent of entry-level doctoral education and changes in Commission on Accreditation in Physical Therapy Education Standards. Given the current challenges noted of academic physical therapy, the focus of this study is to profile current PDs and report their self-identified needs, challenges, and perceptions of their roles. This study provides a detailed workforce profile, including PD’s responsibilities, characteristics, and leadership competencies, which may be used to support and advance leadership in the field of academic physical therapy. Methods. Data were collected using a 35-item survey instrument that was electronically distributed to 241 individuals listed as PDs on the Commission on Accreditation in Physical Therapy Education “Directory of Programs.” Data were analyzed using descriptive statistics, with a narrative review of open-ended responses. Results. Seventy-three PDs responded to the survey (30.3% response rate). Time management was the highest rated management competency and managing change the highest rated leadership competency. Estimated work time by activity was highest for reading and responding to emails and memos. The highest ranked reason that respondents stepped into their roles was to help lead their department. Only 50% received formal orientation before becoming a PD. When asked to rate differences between current job responsibilities and previous expectations regarding the role of PDs, the factors most often cited included the amount of time needed to respond to emails, memos, phone calls, and other communications; these factors also produced the most stress. Discussion. High ratings of time management as an important competency is likely related to the average number of reported working hours (54 hours per week). Prioritization of “understanding the roles and responsibilities of the PD” as an important leadership competency may be reflective of the finding that most PDs come from a faculty member role. The academic experience reported in this study was comparable with findings reported in 2001 and greater than that described in 2014. Shorter duration of time reported by PDs in their current role may be reflective of the proliferation of new programs and challenges with leadership retention. Conclusion. The roles and responsibilities of the PDs in an entry-level physical therapist education program are complex and time intensive. Many PDs face these complexities with little to no formal training. Thus, PDs are challenged by the breadth and depth of the work expected, and competencies required, of them, the enormity of time required to complete this work, and the burden of striving for work–life balance, and yet PDs are generally satisfied with their jobs. However, PDs may benefit from additional developmental offerings, internal and external to the institution, which help them grow to meet the expanding challenges of the role, whether they are new to it or already well established in academe.

Ruthless Sharing of Information

Ruthless Sharing of Information

The Jar of Truthiness: A Novel Class Activity to Develop Leaders With Integrity

Background and Purpose. Truthiness is a gut feeling of being true rather than being based on logic or factual evidence. This educational case report describes a novel class activity called the “Jar of Truthiness” (JoT) that aims to teach the important issues of academic and professional integrity within the affective domain. Case Description. The activity was completed in 3 different ways in physical therapist education programs at 2 institutions. Students were asked to report their incidence of cheating during a specific quiz, or overall during their time in physical therapy school, by placing anonymous responses in a jar (the JoT). Two of the activities were completed during the first year of the program, the other activity was completed during the second year of the program. Outcomes. Most students who participated in the activity reported they had cheated, and some students even reported they lied about whether they cheated. When the activity was repeated over time, the number of students admitting to cheating decreased significantly. Discussion and Conclusion. Students responded positively and were able to link academic integrity to professional integrity when the JoT activity was centered around one specific quiz and completed early in the Doctor of Physical Therapy curriculum. Students experienced negative emotions when the activity was held during the second year and when they were asked broadly about sharing information on any assessment in the program. The JoT activity facilitated class discussions about professional development and stimulated learning within the affective domain. Also, the activity appears to work best during the students' early professional formation so that it can help to frame a culture of integrity within their class cohort.

Current Practices and Perceptions of Admission Criteria at Physical Therapist Education Programs in the United States

Introduction. Entry-level Doctor of Physical Therapy (DPT) programs in the United States (US) have developed admission criteria (AC) to identify applicants most capable of program success; however, there is little evidence to support these criteria. The purpose of this study was to 1) gather data on the use and weighting of AC, 2) explore the perceptions of the value of AC, 3) explore a possible discrepancy between the use of AC and their perceived value, 4) determine whether differences in AC exist between programs with higher versus lower licensure pass rates, higher versus lower student retention rates, and across geographic regions in the US. Subjects. All DPT programs (N = 218) in the US accredited by the Commission on Accreditation of Physical Therapy Education were eligible for recruitment in this study. The survey was completed by a program director, an admission committee chair, or a faculty member familiar with the program's admission process. Of the 218 programs invited to complete the survey, 73 responded with a response rate of 33.5%. Methods. An anonymous, 30-item survey was used for data collection. Descriptive and comparative statistical methods were used on the data as a whole and by subgroups. Results. Undergraduate overall grade point average (GPA), math/science GPA, or verbal and quantitative Graduate Record Examination (GRE) scores were weighted heavily in admission decisions. The personal essay, volunteer hours, and letters of recommendation were not considered predictive of program success. There were significant differences in the proportion of programs that use the verbal and quantitative GRE scores when subdivided by licensure pass rate, either ≥95% or <95% (P = .005 and P = .049, respectively). There were no proportional differences in the utilization or weighting of criteria when programs were divided by student retention rate, either ≥95% or <95%. Geographic differences were found in the use and weighting of AC when comparing the West region with other parts of the US. Conclusion. Previous literature suggests that undergraduate GPA is the best predictor of success in a DPT program; however, this study found no significant differences between the use or weight given to the GPA on licensure examination pass rates or student retention rates. Programs may wish to reconsider requiring a number of criteria that were not weighted heavily or considered to be a top predictor of success in a DPT program, particularly those criteria that are resource intensive.

Temporomandibular disorder content in the curricula of physical therapist professional programs in the United States

ABSTRACT Objective: To describe the status of entry-level physical therapist (PT) education related to the diagnosis and management of temporomandibular disorders (TMD) in accredited, entry-level United States PT programs. Methods: An electronic survey explored specific TMD diagnostic and management curricular content, including the use of evidence-based diagnostic criteria, opportunities for students to interact with individuals with TMD, and faculty qualifications. Results: Eighty-four programs completed the survey. TMD content is covered in the entry-level PT curriculum of almost all (98.8%) responding programs. Content specifically related to TMD averaged 12 h across program respondents (range 1.5–50 h). The majority (68%) of respondents utilized established evidence-based diagnostic criteria. Discussion: Consistent entry-level education guidelines related to TMD and additional post-professional education opportunities are necessary to ensure that patients with TMD are not underserved by the profession of PT by newly graduated PTs.

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

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

Weekend PTA to DPT Bridge Program: An Innovative Educational Alternative

Background and Purpose. Motivated to advance their careers, nontraditional students often choose to return to graduate education. Because of their multiple responsibilities, these students frequently seek alternative educational delivery formats, such as accelerated, hybrid distance, weekend, and bridge programs. In physical therapist (PT) education, bridge programs with online coursework and weekend formats are a relatively new alternative curricular model available for physical therapist assistants (PTAs) who wish to build on their past experiences in a realistic and efficient manner. Thus, this article describes a weekend PTA to Doctor of Physical Therapy bridge program and its outcomes. Method/Model Description and Evaluation. The described bridge program has a weekend format, some online coursework, and formal clinical experiences, clustered at the end of the curriculum. All students entering the program possess a baccalaureate degree from a 4-year institution and an associate degree from an accredited PTA program, as well as a minimum of 1 year of practice experience as a PTA. Multiple outcomes were used to evaluate this model, including focus groups, clinical performance instrument ratings, graduation rates, National Physical Therapy Examination pass rates, and alumni surveys. Outcomes. The average age of the bridge students was 31.5 years, and the average years of experience as a PTA was 7.08 years. The bridge students demonstrated nontraditional student characteristics such as being married, having one or more children, and living out of state. All but 3 students worked more than 20 hours per week as a PTA while in the program. Motivations for students entering the bridge program, as identified through focus group interviews, included finances, curricular fit, time and delivery structure, backup plan, and health care forces. The bridge students also reported expectations of expanded PT career opportunities, financial stability, autonomy as a health professional, and lifetime friendships with their classmates. Most alumni were satisfied with their overall learning experience and reported being adequately prepared to well prepared with their clinical performance skills. The average rating across all clinical performance instrument skills at the end of the final clinical experience was beyond entry level, the average graduation rate was 93.35%, and the ultimate 2-year National Physical Therapy Examination pass rate was 96.15%. Discussion and Conclusion. Major components of the studied model, including experience as PTAs, weekend format, use of online coursework, and clustered clinical experiences, may have interacted to promote positive outcomes for the nontraditional students enrolled in this bridge program. The presented model provides a sound alternative for PTAs seeking to advance their professional development and career.

The Integrated Clinical Education Strategic Initiatives Project-Development of Parameters to Guide Harmonization in Clinical Education: A Scoping Review.

Clinical education curricular models specifically related to integrated clinical education (ICE) vary across physical therapist education programs. The interconnectedness of ICE to the advancement of a shared vision for clinical education in professional physical therapist education needs investigating. The purpose of this scoping review was to: (1) define ICE, (2) define baseline expectations and parameters of ICE, and (3) discern and describe current ICE models. Databases accessed included Medline, MedlinePlus with Full, CINAHL, and CINAHL Plus with full text. A multimodal data collection scoping review was completed. Data collection included survey research, a systematic review of the literature, and a series of focus groups. The McMaster Critical Appraisal Tool assessed methodological study quality. A qualitative, metasynthesis approach was used for data synthesis. Consensus agreement produced results. Twenty-two articles were included in the literature review from the health disciplines of medicine, nursing, physical therapy, occupational therapy, and speech-language pathology. Data synthesis produced 8 parameters defining the factors essential to categorizing clinical education experiences as ICE in physical therapist education. The 8 parameters and ICE definition are supported by a description of models of ICE that currently exist within health profession curricula. Data synthesis followed a qualitative, metasynthesis approach. Themes emerged from the surveys, literature review, and focus group data. Patterns were compared, analyzed, and synthesized to generate the themes and ICE parameters. Selection bias from the literature search could have limited the richness of the model descriptions by unintentional exclusion of articles, and might limit the applicability of results beyond the United States. Sampling bias from survey and focus groups, although purposeful, might have limited a broader description of current viewpoints about ICE. However, the data sources, including multiple health profession perspectives coupled with consensus agreement, provide sound evidence in development of profession-based parameters. The results of this scoping review provide the profession with a standard definition of ICE and parameters that can guide a program in designing a curriculum using ICE experiences as a foundation. A recommended next step is to design education research studies using reliable and valid outcome measures across programs to determine impact and effectiveness of ICE as an educational intervention.

Contemporary Role and Responsibilities of the Director of Clinical Education: A National Qualitative Study

Introduction. Clinical education is of broad and current interest topic in physical therapist (PT) education today. The director of clinical education (DCE) is the core faculty member responsible for the components of the clinical education (CE) curriculum. Previous work has questioned whether the position would be a “dinosaur or a rising phoenix”. The objectives of this study was to comprehensively examine the full scope of the role and responsibilities of the DCE. Methods. A non-experimental, qualitative descriptive study design was used. A constructivist theoretical framework guided the work. Eleven teams of DCEs and program directors (PD) participated in semi-structured interviews. Onsite interviews were conducted by trained interviewers and transcribed verbatim for analysis. A process of thematic analysis was used to develop results. Results. Five themes and 19 subthemes were developed. The DCE was shown to be a value-added position in professional physical therapist programs, whose role and responsibilities are responsive to both internal and external factors to the academy. There is an evolutionary process to the development of a DCE within the academy. A common vision was shared by DCEs and PDs about the future direction of the DCE in today's clinical education marketplace. Discussion. The DCE is a central player in moving academic physical therapist education forward. The patterns of current DCE practice may shed light on plausible reasons for challenges association with the CE atmosphere. Study limitations could include interview bias and bias in analysis. Conclusion. The contemporary role and responsibilities of the DCE were identified, with recommendations for additional studies to enhance the understanding of the DCE in today's academic and clinical environment.

Data-driven Decision Making in Doctor of Physical Therapy Curricula Part I: Program-level Analysis

Background and Purpose. We describe a data-driven internal curricular review process for professional (entry-level) physical therapist education programs. Using National Physical Therapy Exam (NPTE) performance as an outcome measure, we test the ability of individual courses, as well as summary grade point averages (GPAs), to identify students at risk for failure in the first attempt of the NPTE. Methods. National Physical Therapy Exam score was modeled in a simple univariate linear regression on 2 sets of predictor variables: individual course final grades and summary GPAs. First-time NPTE performance was configured in 2 measures: a continuous measure of exam score and a dichotomous pass–fail index. For NPTE score as a continuous measure, linear regression was used to test for association. For pass–fail, we tested for optimal grade or GPA benchmark by systematic thresholding across a range of numerical grades (70–95%) or grade points (1.5–4.0). Methods were demonstrated in the setting of a dataset collected from a single graduate cohort (N = 36), among whom 26 first-time NPTE scores were available. Exploratory analyses tested the sensitivity of this analysis to datasets containing letter grades, and repeatability across 5 cohorts. Outcomes. Grade distributions in individual courses (n = 12) were weak to moderate predictors of NPTE score (range: 0.00 < R 2 < 0.60); curricular GPA distributions (n = 6) were moderate to fair predictors (0.4 < R 2 < 0.7). Overall undergraduate GPA and GPA in prerequisite science courses were found to not predict first-time NPTE score whatsoever. Optimal grade criterion within the classes ranged from 79 to 93 points; optimal GPA criteria ranged from 2.6 to 3.4. At-risk students were identifiable as early as the end of the first semester. Model consistency varied somewhat when replicated across 5 cohorts but showed general consistency in maintaining relative strengths of measured associations. This method showed robustness to conversion to letter-grade format. Discussion and Conclusion. Risk for failure in first-attempt NPTE is a parameter that can be measured, and at-risk students can be identified early in their physical therapist education programs. Internal policy making should be guided by program experience and use data at the per-course or per-semester level.

Impact of a Leadership Thread on Doctor of Physical Therapist Education

Background and Purpose. Health care systems worldwide are investing considerable resources in leadership development programs. 1–4 Yet there is limited evidence as to the effectiveness of leadership training in graduate health care education. The purpose of this study was to investigate the impact of a leadership curricular thread on an entry-level doctor of physical therapist (DPT) program. Design. This study was a prospective repeated measure design. Methods. Participants were 210 students (women (60%), mean age = 25.33 years (3.71) from the graduating classes of 2015, 2016, and 2017. All participants took the online Leadership Practices Inventory Self 5 in their fourth semester and last semester of an 8-semester DPT program. Results. There was a significant improvement in all five of Kouzes and Posner's exemplary leadership practices over time; Model the Way (mean difference = 5.24 [6.80], P = .0001), Inspire a Shared Vision (mean difference = 7.15[8.82], P = .0001), Challenge the Process (mean difference = 6.86 [8.38], P = .0001), Enable Others to Act (mean difference = 3.83[5.36], P = .0001), and Encourage the Heart (mean difference = 3.83 [8.51], P = .0001). Conclusions. The findings support that a focused leadership thread integrated into a 3-year DPT program can have a positive impact on student leadership behaviors.