Physical Therapist Education Research Articles

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

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

Innovation, Risk, and Reward

“Do one thing every day that scares you.” —Eleanor Roosevelt Every time an author puts pen to paper, or more likely fingers to the keyboard, he or she takes a risk. Every time a researcher conceives and conducts a study, he or she takes a risk. Every time that study is about something innovative, the risk increases. Thank goodness for the risk takers! All of the papers in this issue are the result of physical therapists being willing to take these risks to help the rest of us improve our ability to educate the best possible practitioners. Each of the papers is innovative, often in different ways. Addressing the need for standardized outcome measures: Fike et al have added to this body of work on the specific, important topic of cultural competence. Integrated interprofessional education: Kapasi et al have described an innovative program for physical therapist students to earn joint degrees. Technology and social media: Lee and Boissonnault have provided a unique perspective using a radio show as a learning tool. Technology: Sabus and Macauley, and Silberman et al focus on simulation. Sabus and Macauley place simulation in a teaching and learning context and identify many questions that need to be answered as they move to adopt this innovative technique. Silberman et al contribute to the growing body of specific data about the utility of simulation. Health and wellness: Tapley and Patel address both the addition of this relatively new topic in physical therapist education and offer a model that can be used to develop this area of the curriculum. As always, we provide an array of topics to meet the needs of educators in physical therapy as they seek innovative ways to meet their ongoing responsibilities. We encourage all of our readers to take the following risks: identify innovation, study it, and write about it. We will all be better for it!

Effects of Meditation on Stress Levels of Physical Therapist Students

Background and Purpose. Due to the arduous nature of the professional (entrylevel) physical therapist (PT) education program, PT students often experience higher levels of stress than their age and gender-matched peers, which can negatively affect their academic performance and wellbeing. Therefore, finding methods to manage stress is important for students’ wellbeing and academic success. The purpose of this study was to investigate the effect of meditation on stress levels of students in a doctor of physical therapy program. Participants. Twenty-four PT students in their first and second year of an entry-level doctoral degree program participated in this study. Methods. This study examined the stress levels of 24 subjects via blood pressure, morning and evening salivary cortisol levels, and 3 different stress questionnaires (Perceived Stress Scale, General Anxiety Disorder 7, Stress Visual Analog Scale) using a quasi-experimental pretest-posttest design. The intervention was a twice-daily 20-minute beeja mantra-based meditation performed for 8 weeks. Results. All 24 students completed the study with average compliance of 91.6% ± 8.7% (mean ± SD) meditating at least once per day, and 77.3% ± 19.8% meditating twice per day. A paired t test was used to analyze the blood pressure readings, with systolic blood pressure decreasing by 2.9 ± 2.3 (standard error of the mean: SEM) mmHg (P = .022), and diastolic blood pressure decreasing by 4.6 ± 2.9 (SEM) mmHg (P = .005). Four subjects with prehypertensive systolic blood pressure readings prior to the meditation intervention moved into healthy normal range by the conclusion of the study. The Wilcoxon signed rank test was used to evaluate the questionnaires, which showed significantly decreased subjective stress levels (P < .05). No significant changes in mean morning (AM) or night (PM) salivary cortisol levels were found (P > .05). However, 9 of the 14 (64%) subjects who had at least 1 cortisol measurement outside of the normal range (established by ZRT Labs) at the start of the study had both AM and PM cortisol levels in the normal range following the intervention. Discussion and Conclusion. The results of this study show that an 8-week mantrabased meditation program significantly reduces blood pressure, significantly reduces perception of stress based on the subjective questionnaires, and that a 1-day AM/PM cortisol sample may not be sufficient to accurately analyze a subject's true daily cortisol level to show statistical change.

Uncovering a Curricular Model of Self-Care in Pediatric Physical Therapist Education

Introduction.Pediatric physical therapists are faced with complex experiences while serving children and families. Amidst a family's chronic sorrow over the loss of what “might have been,” the pediatric physical therapist may encounter emotional stress in the form of compassion fatigue and burnout.

International Collaboration in Manual Physical Therapy: An Educational Model

Background and Purpose. Internationalization allows the world of higher education to become more connected. International partnerships between physical therapist education programs open new opportunities for learning and cultural exchange. Relatively few international collaborative immersion experiences have been described in the physical therapy literature. The purpose of this article is to describe a model of international educational collaboration between physical therapist education programs at 2 universities in different countries. This collaboration was unique because it provided qualitative analyses of data collected from hosts and guests during the experience. Method/Model Description and Evaluation. Eleven physical therapist students, 1 postgraduate student, and 2 faculty members from the University of Vermont (UVM) traveled to Bond University, Gold Coast, Queensland, Australia. While at Bond University, guest participants collaborated with 36 students in the final year of the Doctor of Physiotherapy program and 11 faculty members in a 2-week international manual therapy collaboration. During this experience, students participated in manual therapy course work, seminars, and cultural activities. Journal data were collected from the students from UVM. Students and faculty members from Bond University were surveyed with quantitative and open-ended qualitative questions that were matched with the journal prompts used for the students from UVM. Interpretative phenomenological analysis methodology was used to determine the meaning of this collaborative experience. Outcomes. The following 3 themes emerged from the student data: learning—the acquisition of new skills both professionally and personally; collaboration—the development of new relationships and opportunities with faculty members and students; and experiencing the “other”—observations made from immersion while abroad. Discussion and Conclusion. Themes identified were similar to those established within the literature. Participants gained life experiences from traveling and insight into their personal and professional goals. The international manual therapy collaboration between UVM and Bond University successfully initiated a new dialogue. The findings support the potential for future collaborative immersion opportunities between education programs to prepare emerging professionals to work in an increasingly global environment.

The Role of Dual Degrees in the Physical Therapist Education Program at Emory University

Background and Purpose. The increasing complexity of medical care in the United States calls for providers to become leaders in various aspects of health care. Combining clinical skills with knowledge of public health and the business/administrative side of health care allows health care providers, including physical therapists, to effectively manage and navigate the changing health care environment and become leaders in their field. The purpose of this paper is to describe the method and process of succesfully establishing dual degree programs in business and public health and in the physical therapist education program at Emory University. Method/Model Description and Evaluation. The process for institutional level agreements, curricular structure, admissions process, and graduation requirements for dual degree program students in the Doctor of Physical Therapy (DPT) and Master of Business Administration (MBA) or Master of Public Health (MPH) at Emory University is described in this paper. Additonally, 2 surveys were conducted: 1 survey of all students in 3 DPT classes (n = 201) and the other survey of dual degree program graduates as of 2013 (n = 8). The surveys evaluated student awareness of the dual degree programs during the DPT program application process and characteristics and perceptions related to the dual degree programs. Outcomes. Eighty-three percent of all students indicted that they were aware of the dual degree programs while applying to our DPT program and 6% indicated it was a key deciding factor in their decision to apply to our program. The graduating grade-point average (GPA) and first time pass rate on the National Physical Therapy Exam (NPTE) licensure of the dual degree students in the DPT program is at least equal to that of the overall DPT class graduating the same year. Moreover, 86% of dual degree program graduates indicated that it made them a more competitive job candidate. Discussion and Conclusion. In addition to fostering interprofessional education, the dual degree programs at Emory show positive outcomes, as all graduates indicated that their dual degree positively impacted their careers, and the majority reported specifically using their dual degree in their career. Also, the graduating GPA and first time pass rate on the NPTE of the dual degree students in the DPT program is at least equal to that of the overall DPT class graduating the same year, suggesting that the burden of an additional course of study was not adversely impacting their performance in the DPT program. At Emory University, the dual DPT/MBA and DPT/MPH programs have been designed to provide students with the necessary clinical, business, administrative, policy analysis, and public health perspectives required to excel as leaders in the future health care system.

Raising the Priority of Lifestyle-Related Noncommunicable Diseases in Physical Therapy Curricula.

Given their enormous socioeconomic burdens, lifestyle-related noncommunicable diseases (heart disease, cancer, chronic lung disease, hypertension, stroke, type 2 diabetes mellitus, and obesity) have become priorities for the World Health Organization and health service delivery systems. Health care systems have been criticized for relative inattention to the gap between knowledge and practice, as it relates to preventing and managing noncommunicable diseases. Physical therapy is a profession that can contribute effectively to patients'/clients' lifestyle behavior changes at the upstream end of prevention and management. Efforts by entry-to-practice physical therapist education programs to align curricula with epidemiological trends toward best health care practices are varied. One explanation may be the lack of a frame of reference for reducing the knowledge translation gap. The purpose of this article is to provide a current perspective on epidemiological indicators and societal priorities to inform physical therapy curriculum content. Such content needs to include health examination/evaluation tools and health behavior change interventions that are consistent with contemporary values, directions, and practices of physical therapy. These considerations provide a frame of reference for curriculum change. Based on 5 years of experience and dialogue among curriculum stakeholders, an example of how epidemiologically informed and evidence-based best health care practices may be systematically integrated into physical therapy curricula to maximize patient/client health and conventional physical therapy outcomes is provided. This novel approach can serve as an example to other entry-to-practice physical therapist education programs of how to align their curricula with societal health priorities, specifically, noncommunicable diseases. The intentions are to stimulate dialogue about effectively integrating health-based competencies into entry-level education and advancing best practice, as opposed to simply evidence-based practice, across professions and health services and to establish accreditable, health promotion practice standards for physical therapy.

CONTENTS AND FEATURES OF “SYLLABI” FOR UNDER GRADUATE PHYSIOTHERAPY EDUCATION IN NORTHERN INDIA: A CROSS SECTIONAL STUDY

Introduction: The syllabus is a description and plan for a course and, if well written, may be a tool that improves student learning, facilitates faculty teaching, improves communications between faculty members about their courses, and assists with monitoring program quality. The level of education for physical therapists should reflect the current and future needs of professional practice and society and changes in physical therapy roles and function as well as changes in the legislation that regulates physical therapy practice. Therefore, through our study, we would assess the existing contents and features of syllabi of various universities conducting Under-graduate Physical Therapy education program in Northern India and throw a light whether they are diverse or in consonance to each other. Aim and Objective: To study the contents and features of various syllabi for Under-graduate Physiotherapy education conducted by various Universities and Institutes of Northern India with special focus on Orthopaedics and relevant subjects. Materials and Methods: There are 24 universities conducting Undergraduate Physiotherapy program in Northern India, 20 universities were found suitable out of which data of 19 universities could be collected. The data was collected by personal visit, from official website of universities, via e-mail and by other sources. The data collected includes course scheme – syllabus, transcript, subject credits and examination scheme Results: The results of this study show that features of syllabi in these universities differ on the basis of total number of academic hours, subject allocation in various years, number of theory and practical hours allotted, percentage weight age of hours, maximum marks, and percentage weight age of marks of each subject. Conclusion: This study concludes that syllabus of the Bachelors of Physiotherapy program in Northern India is variable. The variability is not seen in the program structure rather in: Total number of subjects, Curriculum hours allotted to each subject, Subject allocation in various years, Examination system – annual or semester system, Maximum marks allotted to a subject in the university examination scheme, Total academic hours in a year, Hours allotted for clinical training.

Physiotherapy Education in Germany: Ready for Direct Access?

Objective: The aim of this study is to investigate whether the curricula for physiotherapy education in Germany conform to standards recommended in the World Confederation for Physical Therapy (WCPT) guideline for physical therapist professional entry-level education, published by the WCPT. This Guideline specifies education standards for physical therapists that are able to act as independent practitioners, without referral from another health care professional. Methods: To assess the German curricula of physical therapist education, a list of assessment dimensions was derived from the WCPT-Guideline by means of content analysis. The content validity of this list was estimated by nine experts using Lawshe's method. The German Training and Examination Regulations for Physiotherapists (PhysTh-AprV) and all available regional curricula were studied. All documents were evaluated by 2 independent coders who rated the conformity of the documents with the assessment dimensions. Results: Based on the Lawshe procedure, the whole test content validity index of the 61 out of 67 examined assessment dimensions was 0,84. Cohen's kappa coefficient for intercoder reliability was 0,71-0,97. The German curricula showed high correlation with the WCPT Guideline on many theoretical basic subjects. Fulfillment of some of the requirements showed heterogeneous results. Autonomous practitioners largely lacked special competencies. Conclusions: None of the German educational standards meets the expectations of the WCPT Guideline in terms of direct access. Considering the deficits of the German educational standards and the release date of some of them, a continuous development of the German education does not appear to be adequate. This issue needs to be addressed in the current debate on health policy.

Scholarly research productivity is not related to higher three-year licensure pass rates for physical therapy academic programs.

BackgroundIn the domain of academia, the scholarship of research may include, but not limited to, peer-reviewed publications, presentations, or grant submissions. Programmatic research productivity is one of many measures of academic program reputation and ranking. Another measure or tool for quantifying learning success among physical therapists education programs in the USA is 100 % three year pass rates of graduates on the standardized National Physical Therapy Examination (NPTE). In this study, we endeavored to determine if there was an association between research productivity through artifacts and 100 % three year pass rates on the NPTE.MethodsThis observational study involved using pre-approved database exploration representing all accredited programs in the USA who graduated physical therapists during 2009, 2010 and 2011. Descriptive variables captured included raw research productivity artifacts such as peer reviewed publications and books, number of professional presentations, number of scholarly submissions, total grant dollars, and numbers of grants submitted. Descriptive statistics and comparisons (using chi square and t-tests) among program characteristics and research artifacts were calculated. Univariate logistic regression analyses, with appropriate control variables were used to determine associations between research artifacts and 100 % pass rates.ResultsNumber of scholarly artifacts submitted, faculty with grants, and grant proposals submitted were significantly higher in programs with 100 % three year pass rates. However, after controlling for program characteristics such as grade point average, diversity percentage of cohort, public/private institution, and number of faculty, there were no significant associations between scholarly artifacts and 100 % three year pass rates.ConclusionsFactors outside of research artifacts are likely better predictors for passing the NPTE.

Meeting the global challenge of pain education for physical therapists

Meeting the global challenge of pain education for physical therapists

Effects of early postoperative rehabilitation on infants with congenital cardiac disease

differences between cohorts were demonstrated in student self-assessment of Documentation performance at midterm (p= 0.011), and Financial Resources performance at the midterm and final rating periods (p= 0.022 and p= 0.012, respectively). For Clinical Instructor (CI) ratings, there was a statistically significantly difference between cohorts at the final rating for Financial Resources performance (p= 0.044), indicating a higher CI rating for those students that participated in the CRB instruction. Faculty survey results demonstrated that theCBRapproach benefitted student learning, was not difficult to integrate into existing courses, and enhanced faculty learning. However, faculty had concerns regarding their comfort level with the material and whether it was replacing more clinically oriented content. Conclusion(s):The outcomes generally support the effectiveness of the CBR approach for integrating insurance policy, regulations, and documentation in a professional level physical therapist education program. Students learned to use regulatory and insurance policy information when making clinical decisions and participating faculty did not feel unduly burdenedby the integration of the this content into established case studies. Although the results are encouraging, further research is recommended. Implications: The project presents one method to effectively integrate insurance, regulations, and documentation content into a professional level physical therapist education program. It is hoped that newgraduate physical therapistswill have improved understanding and application of contemporary regulatory and insurance policy to provide efficient and effective patient care.

Increased postural stability in posterior pelvic girdle pain

Results: The literature indicated that the academic and clinical components of physical therapist entry level education pose different challenges for education providers in making accommodations to support those with disabilities. More is written about strategies to support those with visual impairments and learning disabilities, such as dyslexia; little is published on workplace support for physical therapists with other disabilities. Only 25 (24%) of WCPT’s MOs completedthesurvey:4fromAfrica,7fromAsiaWesternPacific, 9 from Europe, 4 from North America Caribbean and 1 from South America. The respondents indicated that education providers do admit students with disabilities but these tend to be mild with visual, hearing and musculoskeletal disabilities most common; however, the incidence of other disabilities is largely unknown. The pattern was similar for reports of practising physical therapists with disabilities. The WHO International Classification of Function and the UN Convention on the Rights of Persons with Disabilities were most frequently reported as guiding physical therapist education (56% and 72% respectively) and practice (64% and 48% respectively). Conclusion(s): Response rates were low and this may reflect differing levels of awareness of the issues in the countries of WCPT’s MOs and the stages of development in education and practice. There are examples of good practice that can be shared. Future work should look at the effectiveness of accommodations for different disabilities and their limitations on scope of practice. Implications: WCPT will use the results to raise awareness and guide physical therapist education and practice internationally by providing a toolkit of collated resources on the WCPT website, signposting good practice examples and promotion of WCPT’s policy statement on disability that supports the inclusion of people with disabilities in the profession.

UMFlint-Nigeria distance transition DPT collaboration – changing physical therapists education and practice in a resource limited country

Background: The Nigeria Society of Physiotherapy and the Medical Rehabilitation Therapists (Registration) Board of Nigeria have set in motion efforts to upgrade baccalaureate entry-level programs in Nigerian Universities to a Doctor of Physical therapy (DPT) entry-level degree. The processes involved in getting approval from various Nigerian Government agencies to commence entry-level DPT will take a few years. An interim strategy to upgrade physical therapists’ (PT) education and practice in Nigeria to the doctoral level, led to a distance transitional DPT (tDPT) collaboration between the University of Michigan-Flint (UMFlint) and Nigeria. The first cohort of the UMFlint-Nigeria tDPT program matriculated in fall 2011 for the 24-months long curriculum. Purpose: This preliminary report identifies factors and challenges related to the successful implementation of a distance tDPT program between a resource rich and a resource limited country. Methods: Matriculation and graduation data of the UMFlint-Nigeria tDPT program were collected. Other collected data include feedback (written, via email) and telephone oral interviews gathered from: (1) matriculated students as they progress through the tDPT curriculum; (2) graduates of the tDPT program; and (3) a handful of employers or current clinical supervisors of matriculated students and tDPT graduates. Factors and challenges contributing to successful program completion were identified. Results: Since Spring 2011, over 50 practicing Nigerian PTs applied for placement in the tDPT program, of which 35 were granted admission (70% acceptance rate). Fourteen of these PTs have graduated with DPT degrees as of fall 2014. Five students required academic remediation, one was dismissed for poor academic performance, while others are still at various stages of completion. Graduates affirmed that the quality of their practice in Nigeria have been positively impacted and noticed by PT colleagues. Graduates reported that theynow receive a higher rate of referrals fromphysicians who noticed better patient outcomes following completion of their DPT degrees. Graduates have also been identified as better clinical instructors to entry-level physical therapy students; and are more competitive for faculty positions in a new/developing PT entry-level education program in Nigeria. Themost impactful tDPT courses included: Systems Review andClinical DecisionMaking (includingDifferential Diagnosis), Evidence-Based Practice Patterns, and Medical Imaging. Factors which ensured success included dedication of UMFlint professors, IT Support, administrative assistance and guidance throughout the program. Challenges included yearly increasing tuition costs at the UMFlint; poor Internet infrastructure, constantly interrupted electricity supply in Nigeria, security challenges and civil unrest in some parts of Nigeria where students reside. Conclusion(s):A collaborative distance tDPT program is already changing education and clinical practice in Nigeria, one physical therapist at a time. Program cost was identified by graduates and current students as themost impactful factor determining ability to complete the tDPT program. Security, Internet and electricity infrastructural challenges in Nigeria were the next most impactful factors. Implications: Distance tDPT program has the ability to change the level of education, clinical practice and quality of physical therapy patient care and outcomes in a resource limited country, if some factors and challenges identified in this preliminary report can be managed.

A randomised controlled trial on the effectiveness of a lateral glide cervical spine mobilisation on cervicobrachial (neck and arm) pain

GAS-education in other countries and cultures, could provide additional depth for the teaching GAS method. Implications: In the future GAS-method should be included in the basic education of physiotherapists and other professionals in rehabilitation services. However also continuous education courses will be needed for professionals who are already ion the working life.

Checklists to manage Pain Induced by Exercise and Mobilization (PIEM) during physical therapy programs: PIEM checklists for practitioners and physiotherapists

ObjectivesIdentify key informational and educational items (“messages”) to provide to physicians (general practitioners and specialists) and physiotherapists for the management of pain induced by exercise and mobilization (PIEM). Develop checklists to improve this management in daily practice. Material and methodsThe Delphi method for consensus-building was used to identify informational and educational messages for health professionals who deal with PIEM. Informed by the results of an extensive qualitative study, a panel of experts from 5 medical and paramedical disciplines concerned with PIEM and a representative of a patients’ association were interviewed individually and iteratively in order to obtain a single, convergent opinion. ResultsDelphi consultation helped to determine 9 areas corresponding to 54 key messages of information and education for doctors and physiotherapists who deal with PIEM. These messages relate to: defining, characterizing, identifying, and evaluating PIEM; identifying factors that may cause or increase this pain; informing the patient in order to avoid misinterpretation of PIEM; preventing and treating PIEM; and dealing with it during physical therapy sessions. The method also enabled us to develop 2 synthetic instruments (checklists) — 1 for physicians and 1 for physiotherapists — to help with the management of this pain. ConclusionConsulting a panel of experts comprising different categories of actors dealing with PIEM on the basis of a thorough qualitative diagnosis in order to identify messages for a training program makes it possible to harmonize programs with the expectations of patients and the problems encountered by professionals. The formulation of this program and the institutionalization of two checklists should enable health professionals to identify, qualify, and deal more effectively with PIEM.

Genetics Education Is Viewed as Important, but Not a Priority in Physical Therapist Education

Background and purpose. Little is known about genetics education in physical therapist (PT) education programs. The purpose of this study was to assess the status and perception of genetics education in accredited United States (US) PT education programs. Methods. Two electronic surveys were sent to the following recipients: (1) 205 program directors of PT education programs (PD), and (2) 3,177 subjects drawn from faculty lists of PT education programs and American Physical Therapy Association (APTA) Education Section members (PTED). The 18-item PD survey sought to identify the status of genetics education in PT education programs. The 32-item PTED survey sought to assess genetics perspectives relative to the National Coalition for Health Professional Education in Genetics (NCHPEG) core competencies in genetics. Results. There were 118 respondents (57.6%) to the PD, and 602 respondents (18.9%) to the PTED. Respondent exposure to genetics literacy came primarily from outside reading (PD and PTED = 53%), while 19% of PD and 26% of PTED had no exposure to genetics literacy. Genetics information was included in courses of 85% of programs, while 15% reported no genetics instruction as a part of the curriculum. Over 60% of respondents believed that genetics literacy was important in the treatment of patients, but > 50% believed genetics education was a priority for PT students and clinicians. PTED respondents noted a mean agreement of 73.7% to the 3 NCHPEG baseline competencies, 83% to the 11 NCHPEG knowledge competencies, 60% to the 5 skill competencies, and 96.5% to the 2 attitude competencies. Discussion and Conclusion. PT educators agree about the importance of genetics literacy in rehabilitation, but most don't see genetics education as a priority for PTs. Increasing PT educator awareness about the impact of genetics on rehabilitation is necessary to alter the apparent disparity between genetics literacy and education among PTs.

Critical Thinking Skills and Learning Styles in Physical Therapists Trained in India Enrolled in a Masterʼs Program

BACKGROUND AND PURPOSEThe Commission on Accreditation in Physical Therapy Education (CAPTE) emphasizes the importance of physical therapist (PT) education programs providing opportunities for students to develop critical thinking skills.1 Despite this emphasis, the development of these skills often is not directly measured in PT education programs. Thus, there is a need in the profession to assess whether the physical therapy curriculum is promoting critical thinking skills in students as they advance through their programs. The purpose of this study was to measure the acquisition of critical thinking skills and describe curricular characteristics used to facilitate the development of critical thinking skills in internationally trained PTs attending a postprofessional master's degree program in the United States. Currently, there is no literature looking at the development of critical thinking skills and various physical therapy curricular characteristics. Many internationally trained PTs attending postprofessional master's degree programs become licensed and practice in the United States. Therefore, there is a need to determine whether PT education programs are developing critical thinking skills in these students as they enter this challenging health profession.As a result of a multidisciplinary project coordinated by the American Philosophical Association, a consensus definition of critical thinking was published in 1990: thinking is the process of purposeful, self-regulatory judgment. This process gives reasoned consideration to evidence, contexts, conceptualizations, methods, and criteria.2Critical thinking is a process requiring judgment and, as such, it is not purely a method to be learned, but rather a process including both cognitive and affective domains.3 Ultimately, through this process a decision is made based on the available evidence, using appropriate conceptualizations, methods, and evaluative criteria. There is a distinct difference between critical thinking and problem solving. Problem solving focuses on a specific problem and finding solutions to this problem. Meyers points out that, through the process of critical thinking, one seeks to raise questions considering all aspects of the situation, along with critiquing the possible solutions.4 Critical thinking is a crucial skill for any clinician to possess in order to meet the multiple demands of the health care system. Although the profession of physical therapy makes it clear that critical thinking skills are necessary skills for new graduates to possess, evidence of the assessment of these skills in students is limited in the literature.The acquisition of critical thinking has been studied in different health care professional students. The majority of the studies have been conducted with nursing students, with a few studies focusing on physical therapy, occupational therapy, pharmacy, and medical students. A systematic review published by Brudvig et al5 reviewed 19 studies: 10 from nursing, 5 from physical therapy, 1 from occupational therapy, 2 from pharmacy, and 1 from medicine. Inclusion criteria included the use of the California Critical Thinking Skills Test or the Watson Glaser Critical Thinking Appraisal to measure critical thinking skills. This review reported that the studies in physical therapy showed mixed results and lacked adequate statistical power. A recent study by Huhn et al6 reported that the Health Science Reasoning Test (HSRT) detected an increase in critical thinking skills in students in 2 PT education programs from start to completion.There is no available literature to date on critical thinking skills in internationally trained PTs. In 2013, 4,928 internationally trained PTs took the National Physical Therapy Examination (NPTE) (personal communication, FSBPT, December 2013). With a pass rate ranging from 25% to 30%, approximately 1,250 to 1,475 internationally trained PTs become licensed PTs eligible to practice in the United States. …

In Pursuit of Best Practice in Physical Therapy Education

'Quality is not an act, it is a habit-AristotleThe concern about quality in physical therapist education is everywhere! The profession as a whole, particularly members of the profession committed to academic and clinical teaching roles, is engaged in several major projects to identify best practice in physical therapist education. The American Physical Therapy Association (APTA), Education Section, American Council of Academic Physical Therapy (ACAPT), Commission on Accreditation of Physical Therapy Education (CAPTE), and Federation of State Boards of Physical Therapy (FSBPT) have been supportive of several profession-wide projects over the past few years that will contribute to the debate surrounding best educational practice for physical therapist education. Consider the macro-level focus of several of these projects:* ACAPT supports the Benchmarks for Excellence task force, which seeks to develop quantitative and qualitative benchmarks that represent excellence in physical therapist education, against which, programs could assess themselves.* ACAPT, APTA, the Education Section, and the FSBPT collaborated to develop a shared vision for enhancing clinical education in physical therapy. A 2-year process of conferences, invited papers (published in JOPTE as a supplement in May 2014), and webinars culminated in the Clinical Education Summit in October 2014. Over 450 participants agreed on 15 recommendations that they believe represent best educational practice in physical therapist education. ACAPT will consider how to proceed with these recommendations for the profession this year.* APTA, the Education and Orthopeadic Sections, and ACAPT collaborated to fund a research project, Excellence and Innovation in Physical Therapist Education for the Twenty-First Century (PTE21). The research team has followed the research methods of former studies sponsored by the Carnegie Foundation for the Advancement of Teaching. These studies in medicine, nursing, clergy, engineering, and law focused on identifying what curricular structures, instructional practices, assessment approaches, and environmental/institutional characteristics optimally support the preparation and development of professionals in training. Preliminary data from this national study of physical therapist education in academic and clinical settings have been presented at conferences, with the final work expected to be published in 2015 and 2016.* APTA has identified the importance of quality physical therapist education through action of the 2014 House of Delegates by adopting a position statement on excellence, as well as a charge to identify best practices in clinical education. Also, APTA has charged a task force to provide strategic advice, counsel, and options to the Board of Directors regarding current and emerging issues impacting the ability of physical therapist education to produce practitioners that meet the needs of the current and evolving health care system. We are fortunate as a profession to havethe resources of these organizations and the commitment of learned colleagues to envision common and effective educational practices in the future. …

A Case-Based Reasoning (CBR) Model for the Integration of Insurance Policy and Regulations in Professional Physical Therapist Education

Background and Purpose. The evolving health care environment brought about by health care reform and constantly changing insurance and regulatory requirements poses a great challenge for today's physical therapists (PTs). Because professional level PT students are expected to integrate these requirements into patient management, educational programs should explore ways to enhance student learning in these areas. The purpose of this manuscript was to describe a case-based reasoning (CBR) approach to integrating insurance, regulations, and documentation content into a professional level PT education program, assess the outcome on students’ clinical performance, and report faculty perceptions of the curricular changes. Method/Model Description and Evaluation. Faculty in a professional level PT education program developed a CBR instructional method to integrate insurance, regulatory, and documentation content throughout the curriculum. The goals for the curriculum change were to have thirdyear students begin their internships with the ability to analyze and apply appropriate insurance and regulatory policies to all patient cases, appreciate how policies affect patient management and access, and effectively document in the medical record. In addition to adding didactic material and interactive learning experiences, faculty modified existing cases used in clinical management courses. This modification resulted in students experiencing progressively more complex clinical cases layered with insurance and regulatory challenges. Outcomes. To determine the effectiveness of the CBR method, student performance was measured using 2 domains (financial management, documentation) of the Clinical Performance Instrument (CPI) during the student terminal clinical internship for 2 cohorts of students. The first cohort included all PT students for the 2 years prior to the implementation of CBR experiences, while the second cohort included 2 years of PT students who participated in CBR learning. Significant statistical differences between cohorts were demonstrated in student self-assessment of documentation performance at midterm (P = .011) and financial resources performance at the midterm and final rating periods (P = .022 and P = .012, respectively). For clinical instructor (CI) ratings, there was a statistically significantly difference between cohorts at the final rating for financial resources performance (P = .044), indicating a higher CI rating for those students that participated in the CBR instruction. Participating faculty survey results demonstrated that the CBR approach benefitted student learning, was not difficult to integrate into existing course learning experiences, and enhanced faculty learning. However, participating faculty had concerns regarding their own comfort level with the material and whether it was replacing more clinically oriented content. Discussion and Conclusion. The outcomes generally support the effectiveness of the CBR approach for integrating insurance policy, regulations, and documentation in a professional level PT education program. Students learn to use regulation and insurance policy information when making clinical decisions and participating faculty did not feel unduly burdened by the integration of this content into established case studies. Although the results are encouraging, further research is recommended.