Physical Therapist Education Research Articles

Education and Work of Physical Therapists Who Treat Sexual Health Concerns

The Section on Women’s Health (SoWH) is a part of the American Physical Therapy Association and has members who treat sexual health concerns. Although the use of physical therapy to resolve sexual pain concerns among women is well-established, it is not clear how physical therapists adept at addressing sexual health concerns become interested in this specialty, how they gain their training, and how much they treat sexual health concerns among men. This exploratory study examined these issues in a survey of SoWH members. After incontinence or constipation problems, female patients with sexual pain are seen more than other sexual health concerns. Believing that male patients with sexual health concerns can benefit from physical therapy is influenced by working with such patients. Work experiences and personal experiences motivated physical therapists to address sexual health issues. Participants wanted more training in sexual health matters from their programs and sought extra training for their sexual health skills. To develop the next generation of physical therapists in this specialty, physical therapy programs could collaborate with physical therapists who specialize in women’s sexual health to provide guest lectures, rotations for interested students, and published articles on their work.

Perceptions of Doctor of Physical Therapy Students and Faculty About Graduate Assistantships

Introduction. Graduate assistantships provide students with financial assistance and the opportunity to gain professional experience. Doctor of physical therapy (DPT) students face increasing student loan debts, and graduate assistantships are one method to provide financial support and opportunities for professional involvement. Responsibilities of graduate assistants (GAs) typically include teaching, research, and/or administrative activities as assigned by their faculty supervisor. The purposes of this study were to 1) explore the perceptions of GAs and their faculty supervisors about entry-level DPT graduate assistantship responsibilities and experiences and 2) develop a conceptual framework to describe the graduate assistantship experience in a physical therapist education program. Previous authors have demonstrated that GAs face challenges if there is a lack of clear expectations, training, or mentorship. However, with effective training and faculty supervision, GAs can receive valuable professional experience. In addition, GA faculty supervisors may benefit from increased research productivity and assistance with teaching responsibilities. There is limited research about the experiences of GAs and the faculty supervisors in health care professions, and no research about physical therapist education was found. Methods. There were a total of 33 subjects: nine full-time physical therapy faculty members and 24 entry-level DPT students. In this qualitative study, subjects completed a demographic form and participated in a focus group interview with peers. Guiding questions focused on the following: reasons for becoming a GA/faculty supervisor, fairness of compensation, description of assigned roles and responsibilities involved with graduate assistantships, the benefits and challenges of being a GA/faculty supervisor, and future recommendations. Descriptive statistics and the constant comparative method were used for data analysis. Themes and concepts were generated and a conceptual framework was developed. Results. Participants described GA responsibilities that included teaching, research, and/or administrative activities. All participants agreed that the financial compensation for GAs was fair and, despite some challenges, the graduate assistantship experience was beneficial for both students and faculty. Examples of benefits for students included increased knowledge about teaching and research, improved communication/time management skills, and a collegial relationship with faculty. Faculty benefits included increased productivity, training in new technology/computer skills from GAs, and gratification related to growth of the GA. Concepts with accompanying themes included the following: factors for a successful experience (supportive structure and relationship building), transitions in roles and relationships (changing roles and evolving relationships between the GA and the faculty supervisor), and influences on professional development (doing and becoming). Discussion and Conclusion. The graduate assistantship experience can be beneficial for students and faculty. The conceptual framework illustrates how the concepts contribute to a successful experience and facilitate professional development of both students and faculty. These findings may assist faculty in effectively mentoring GAs and help encourage physical therapist educators to develop GA positions and establish training programs for both students and faculty.

Purposeful Recruitment Strategies to Increase Diversity in Physical Therapist Education

Background and Purpose. A more diverse physical therapist (PT) workforce is needed to meet the rapidly changing demographic of the United States. To achieve this increased representation within the profession, PT education must recruit, admit, and retain a more diverse student body. A comprehensive definition of underrepresented minorities (URMs) in professional physical therapy education was recently expanded to include educational, economic, and geographic disadvantage in addition to race and ethnicity. Position and Rationale. The PT profession has not examined the disadvantaged profile of its applicant pool or student demographic, but this expanded URM definition now supports this effort. This position paper reports on a survey conducted by the American Council of Academic Physical Therapy's Diversity Task Force designed to examine recruitment into PT education through the lens of the new URM definition, with a focus on how students from underrepresented and disadvantaged backgrounds decide to pursue a PT career. The position taken was that identifying potential differences in how URM students achieve this decision will support the development of purposeful recruitment strategies for students from URM groups. Discussion and Conclusion. Students from URM backgrounds reported different critical decision ages, as well as different use of or preference for resources to learn about the PT career and to prepare for application to DPT programs. Although personal experience with physical therapy was the primary influence on white students' decision to pursue a PT career, values and interests were equally impactful on this decision for disadvantaged students. Both nonwhite and disadvantaged students were also more influenced by exposure to the patient–therapist relationship and by inclusion and diversity than white students. This paper uses these data to support the need for different strategies and tailored recruitment of URM students into physical therapy education programs.

International Service-Learning: Feedback From a Community Served

Introduction. Mutual benefit to participants and recipients of international service-learning (ISL) is often assumed by academic institutions when bringing medical/health care and education to underserved countries. Research documenting feedback from host communities is needed in all disciplines, including physical therapy. Overall, host communities seem to appreciate collaborations with ISL visiting teams; however, these communities may endure hardships unbeknownst to visiting partners such as reinforcement of negative attitudes, disruption of community relations and dynamics, interactions with culturally insensitive visitors, and poor quality care. The purpose of this study was to collect and document feedback from a host community after a 2-week ISL experience with Doctor of Physical Therapy (DPT) students and faculty. Methods. Twelve community leaders who interacted daily with DPT students and faculty were interviewed. Individual interviews were completed and transcribed. The constant comparative method was used to generate themes. Results. Overall, the community felt that their the interactions with the ISL team 1) improved local cultural attitudes about disability, 2) improved awareness of the role of physical therapy, 3) fostered strong, respectful relationships between the community and team, and 4) strengthened the desire to sustain the partnership. Discussion and Conclusion. The host community was very satisfied with the partnership and wished to strengthen relationships for long-term sustainability. Recommendations for the ISL curriculum in physical therapist education were identified or reinforced from this study.

Postprofessional Physical Therapist Education: A Report From Two Regions of the World

Introduction. Leaders in the physical therapy profession have identified a global need for high-quality postprofessional physical therapist (PT) education. However, the educational needs and realities for busy practicing PTs have yet to be identified. Therefore, the purpose of this research was to provide information to assist institutions around the world in designing appropriate postprofessional education programs for PTs. Methods. The study sample consisted of 10 years of alumni from a Doctor of Physical Therapy (DPT) program in the United States of America (USA) and 7 years of alumni from an equivalent DPT program in Australia (AUS). Data were collected via survey and were analyzed using descriptive statistics and phenomenological analysis. Results. Approximately 10% of participants from each country had completed a formal postprofessional education program. More recent graduates in both groups reported the greatest interest in postprofessional education. Both groups showed high interest in returning to their alma maters, utilizing a hybrid learning format, and participating in international collaborations. Orthopedics and musculoskeletal were the specialty areas of greatest interest in the USA and AUS, respectively. Barriers to pursuing postprofessional education identified by both groups were cost and lack of access/locations. Focus group participants identified access to a mentor and increased recognition as important aspects of postprofessional education. Discussion and Conclusion. Universal interest in, and barriers to, postprofessional physical therapy education exists worldwide. Offering hybrid education including international collaboration and mentoring targeted at recent graduates may be effective in meeting the needs of busy PTs. Institutions looking to establish successful postprofessional education programs should take cost, access, time, and area of study into consideration.

Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education

Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education

Physical Therapist Student Outcomes of Interprofessional Education in Professional (Entry-Level) Physical Therapist Education Programs: A Systematic Review

Background and Purpose. Traditionally, the physical therapy profession has been involved with interprofessional education (IPE) and collaborative practice. However, IPE was not a requirement for professional (entry-level [EL]) physical therapist (PT) curriculum until recently when the Commission on Accreditation in Physical Therapy Education (CAPTE) incorporated IPE into the Standards and Elements for professional (EL) physical therapist education programs. Therefore, this systematic review is aimed at synthesizing the available evidence regarding physical therapist student outcomes associated with various IPE instructional methods embedded in professional (EL) physical therapist education programs globally. The evidence gathered may help guide educators when developing and implementing IPE curricula into professional (EL) physical therapist programs. Methods. This systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for searching and reporting processes. Individual searches were developed for PubMed, ProQuest Nursing and Allied Health, and CINAHL. The EBSCOhost databases, ERIC, Education Full Text, and Education Research Complete, were searched simultaneously using a similar comprehensive search strategy that included search terms related to 1) education, 2) interprofessional, and 3) physical therapy. Results. Thirteen articles met the inclusion criteria. Outcomes were measured by 6 different outcome measures (OMs) and achieved by a variety of teaching and learning methods. Multiple studies demonstrated an improvement in attitudes toward perception of and perceived need for collaboration among health care professionals of PTs, as well as improved competency, and autonomy after participation in IPE. Physical therapists valued shared leadership and participation, as well as displaying a readiness to learn with other disciplines. Some studies reported negative outcomes related to the ability of shared learning to increase understanding of clinical problems and improve interprofessional communication and teamwork. Conclusion. Both positive and unintended negative outcomes may result from IPE. The OMs reported in this review measure components of teamwork, roles and responsibilities, communication, learning/reflection, patient focus, and ethics/attitudes. Using more than 1 OM seems to measure the outcomes of IPE more effectively. In summary, current evidence suggests an overall positive impact of IPE on PTs' competency and autonomy, teamwork, collaboration, communication, and readiness to learn achieved by a variety of instructional methods.

Clinical Reasoning: Survey of Teaching Methods and Assessment in Entry-Level Physical Therapist Clinical Education

Background. Clinical reasoning skills have been identified as an integral part of physical therapist education developed in both the academic and clinical settings. There is limited understanding of clinical instructors (CIs) expectations related to the anticipated level of clinical reasoning (CR) skills achieved by students and how CR is taught and assessed in the clinic. Objective. The purpose of this research was to explore how CIs teach and assess student physical therapists' CR skills and garner an understanding of CIs' expectations related to CR skills attained at various levels of clinical experience. Design. A descriptive, cross-sectional survey was used to gather data from CIs. Methods. Participants identified from an American Physical Therapy Association database of credentialed CIs were asked to complete an 18-question electronically delivered survey. Results. A nationwide sample of 749 CIs completed the survey. The data clearly demonstrated that CIs value and recognize the importance of clinical education in the development of CR. They also value the use of engaged discussion and reflection to foster the development of reasoning skills. Most CIs did not expect students to achieve entry-level CR skills during the third year. Conclusions. Clinical instructors see the importance of clinical experiences and engaged discussion to foster the development of CR. Further research is needed to understand why most clinical educators did not expect students to achieve “entry-level” CR skills as defined by the Clinical Performance Instrument by the final year of the program.

Overview of Curricula About Pain in Physical Therapist Education Programs in Brazil: A Faculty Survey.

Educating health professionals about pain (pain education) during undergraduate studies may be an important step in changing ineffective pain management practices. The objective of this study was to assess the extent of pain education in current accredited physical therapist education programs in Brazil. This study was designed as a cross-sectional survey study. Brazilian physical therapist education programs accredited by the Ministry of Education participated in this study. The main outcome measures were frequency of a specific curriculum about pain (pain curriculum) in physical therapist education programs and content analysis according to discipline-specific pain curriculum recommendations developed by the International Association for the Study of Pain. A total of 811 physical therapist education programs in Brazil were identified. After duplicates and universities no longer offering a physical therapist education program were removed, a total of 566 physical therapist education programs were left; 399 of the 566 (70.5%) provided information about the curriculum on their websites. Among the identified physical therapist education programs with available curricula, 26 (6.5%) had a specific course about pain (pain course), covering a mean of 44.3 hours. Limitations included the inability to cover all the physical therapist education programs in Brazil and the inability to identify whether pain content is distributed in other disciplines such as pediatrics, geriatrics, and neurological and orthopedic physical therapy. Most Brazilian physical therapist education programs do not offer a specific pain course. When a pain course is presented in the curriculum, some content recommended for physical therapist education programs by the International Association for the Study of Pain is not covered. The absence of a pain course in physical therapist education programs may have implications for pain management. To the best of our knowledge, this is the first study about pain education in physical therapist education programs in Brazil.

Experiential Learning Enhances Physical Therapist Student Confidence in Management of Neurologically Involved Adults and Children

Introduction. Clinical experiences are an integral part of professional physical therapist (PT) education programs. Hands-on engagement helps foster the critical thinking skills necessary to successfully navigate the complexity of clinical practice during a PT student's final clinical internships. As PT students advance through an entry-level professional program, their clinical decision-making skills improve; however, they lack self-confidence in working with both adult and pediatric patients presenting with neurological impairments. The purpose of this study was to explore the effect of experiential learning using community volunteers (both adults and children) with activity and participation restrictions as a result of neurological insult or developmental delay on PT student perceived self-confidence. Methods. A convenience sample of 128 students currently enrolled in a PT education program were recruited. A pretest–posttest survey assessed the students' self-perceived confidence in the evaluation and treatment of a neurologically involved individual across the lifespan. The students completed 4 weeks of experiential learning with one adult and one pediatric community volunteer with a neurological condition in small groups. The four sessions included an initial evaluation, two treatment sessions and one discharge reassessment. An exploratory factor analysis was completed to validate the tool and to determine the factors that make up the survey. Qualitative data (open-ended questions) were analyzed using a grounded theory approach. Results. On average, students reported more self-perceived confidence in the posttest survey than in the pretest survey. This difference was significant t(127) = −13.841, P < .001. Conclusion. Students expressed that more exposure and increased time spent with neurologically involved adults and children could improve their confidence. This study supports the use of experiential learning in PT education programs.

Developing a Tool to Assess Physical Therapist Educational Program Quality With Engagement Theory: The American Council of Academic Physical Therapy Benchmarks for Excellence Task Force

Background and Purpose. The American Council of Academic Physical Therapy (ACAPT) convened the Benchmarks for Excellence (BenEx) Task Force with a charge to define and assess excellence in physical therapist education. The purpose of this article is to describe the process employed by the BenEx Task Force in the development of a tool to measure physical therapist education program excellence, to provide evidence for the validity and reliability of the tool, and to describe the future goals of the BenEx Task Force. Method/Model Description and Evaluation. The BenEx Task Force members adopted the Engagement Theory of Program Quality as a framework for defining excellence. In 2013, the task force developed the initial Physical Therapist Measure of Educational Program Quality survey. The task force worked closely with a Web site design company to develop a comprehensive item database, survey format, survey delivery mechanism, data-entry process, and data summary and interactive display platform. The final student survey included 36 elements representing 11 attributes within the 5 clusters of quality hypothesized by the Engagement Theory, and the faculty survey included 38 elements representing 13 attributes within the 5 clusters. Outcomes. In 2015, 88 of 193 (46%) ACAPT-eligible programs participated in the survey: 706 students, 717 faculty, and 88 program directors. The analyses revealed some areas of the survey that may require revision; however, 35 of 36 elements on the student survey and 30 of 38 elements on the faculty survey met the expected acceptable alpha reliability coefficient levels (≥.70) of internal consistency. Discussion and Conclusion. Defining excellence in physical therapist education is a difficult undertaking. The process used by the BenEx Task Force to begin the work of defining excellence in physical therapist education underscores the need for continuous engagement of stakeholders. Enlisting literature from other areas of education and a theoretical framework helped to present a cohesive structure that allowed ACAPT members to agree to the process enough to move the project forward. Furthermore, a transparent process promoted success. Continued data collection and analysis will determine the inclusion/exclusion of specific items that may not fit well into particular elements, any necessary survey revisions, and facilitation of the development of benchmarks in physical therapist education.

Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education

Background and Purpose: Recent changes to the standards of accreditation implemented by the Commission on Accreditation in Physical Therapy Education require that a minimum 50% of all core faculty must hold an academic doctoral degree such as a PhD. Enforcement of these requirements will begin in 2020. Clearly, these changes will present challenges to the growing need for qualified faculty in physical therapist education programs. The purpose of this commentary is to provide a brief review of recent changes in the academic credentialing requirements for core faculty members and to offer our rationale for supporting these new standards. Reasons to Support the New Standards: The importance of maintaining the new requirements is supported by a recent decline in full-text scholarly products from core faculty across the profession, with faculty relying much more on presentation abstracts to meet accreditation requirements. The collective effect of decreased publication of full-length articles suggests that the generation of scholarly products in the field of physical therapy is at risk. In addition, a lack of scientific dissemination is likely to reduce the profession's ability to advance the profession through translational science. The minimum 50% core faculty with earned academic degrees standard also serves to aid in longevity and resultant stability of a core faculty through increased rates of successful promotion and tenure. Finally, recently published studies on methods of proposed excellence in physical therapist education suggest the need for continuing emphasis on physical therapist education in increased depth and breadth of foundation knowledge is needed to prepare graduates for a more complex health care environment. Faculty who possess terminal academic degrees in the field of physical therapy and foundational sciences are best prepared to take on this challenge. Summary: The practice of physical therapy is changing, and the education of entry-level students must adapt to keep current with those changes. We, as academic leaders in the profession, must insist on retaining, and possibly even strengthening, the requirement of a minimum 50% mix of terminally academic degreed faculty within our core faculty.

Positioning Academic Physical Therapy for Excellence Through Contemporary Accreditation Standards

Background and Purpose. The specialized accreditation process governed by the Commission on Accreditation in Physical Therapy Education (CAPTE) exists to assure the quality of professional education in physical therapy. Collectively, the ideas encumbered in CAPTE's Standards and Required Elements represent contemporary expectations of the profession for its own education. The status of “accredited,” then, serves as a public statement of success in meeting these expectations. Over the years, because the CAPTE became the sole agency recognized to evaluate physical therapist education, the profession has adjusted its expectations in response to changes in the health care environment, scientific evidence for practice, visibility and effectiveness in the academic environment, and advocacy by multiple stakeholders. These adjustments demonstrate the dynamic nature of accreditation and the power of professional testimony to strengthen the process and outcomes of CAPTE's work. The purpose of this article was to advocate for modifications to three elements of standard 4 that address the qualifications of the faculty and leadership of physical therapist education programs. The case will be made that, as currently written, these three elements may be constraining the routes by which programs can show compliance with expectations of excellence in physical therapy education. Position and Rationale. Upon this historical foundation, further change in accreditation expectations will undoubtedly occur. Assuring the appropriate direction of such change is the responsibility of all stakeholders (ie, practitioners, scientists, teaching faculty, and consumers). In this article, we have drawn upon our collective academic experience in diverse environments to propose that the CAPTE reconsiders the requirements that 1) all core faculty possess a doctoral degree without also requiring other types of formal advanced training beyond the clinical doctorate degree (standard 4A), 2) the program director must hold an academic doctorate (standard 4G), and 3) at least 50% of core faculty must possess academic doctorates (standard 4K). We assert that the current requirements for faculty and leadership qualifications undervalue legitimate qualifications and expertise that would otherwise enhance academic physical therapy and would be well aligned with CAPTE's new core mission “to ensure and advance excellence in physical therapy education.” 1 Discussion and Conclusion. Professional responsibility and public accountability are the bedrocks of accreditation. While fully embracing these bedrocks, the accreditation processes of other doctoring professions preserve a measure of institutional prerogatives to determine how best to meet the quality standards of the discipline while fulfilling their unique missions. We seek revision of three elements included in standard 4 to avoid being overly restrictive and to reduce the risk of unintended consequences occurring that are not in the best interests of the profession nor the public we serve. We abide by Atul Gwande's proposition that “Betterment is perpetual labor.” 2 If we are truly committed to seeking excellence in physical therapy education, we must continuously work toward ways to improve the standards used to evaluate how we educate the next generation(s) of physical therapists.

Reliability, Internal Consistency, and Minimal Detectable Change of the American Physical Therapy Association Professionalism in Physical Therapy: Core Values Self-Assessment

Introduction. The American Physical Therapy Association identified professionalism as a key component of the professions' growth and advancement in the 21st Century. Physical therapist education programs are using the professionalism in Physical Therapy: Core Values Self-Assessment (PCVSA) for the evaluation of their students and for research. The objective of this study was to determine the extent to which the PCVSA provides a reliable measurement of professionalism in physical therapist students. Methods. The study sample consisted of 267 previously completed PCVSAs from physical therapist (PT) students and 29 paired PCVSAs from a current cohort of PT students. This quantitative, descriptive study examined the reliability, internal consistency, and minimal detectible change of scores from the PCVSA. Scores from previously completed PCVSAs were used to investigate internal consistency reliability using Cronbach's alpha. Scores of PCVSA from current students were used to examine test–retest reliability using the intraclass correlation coefficient (ICC) and standard error of measurement. Minimal detectable change scores were also calculated. Results. The total PCVSA score had excellent score consistency (α = 0.97) and stability (ICC = 0.90; 95% confidence interval [CI] = 0.78–0.95). Standard error of measurement on the total score was 5.4 points. Minimal detectable change score at the 90% CI was 13 points (95% CI was 15 points). Discussion and Conclusion. Utility of the total PCVSA score for formative assessment of professionalism of PT students is supported. Minimal detectable change scores can be used to track professionalism change over time. The PCVSA should not be used for high stakes decisions regarding student progression due to items that may not be appropriate for students.

Physical Therapist Student Difficulty in Clinical Education Settings: Incidence and Outcomes

Introduction. Physical therapists must have the academic and clinical preparation for the demands of current practice across the lifespan and continuum of care. Predictors of student physical therapist (SPT) academic success have been investigated, but there has been limited inquiry into factors associated with difficulty during clinical experiences (CEs). Challenging clinical learning environments are reported to influence student success in other disciplines, but this information is lacking in physical therapist student literature. Physical therapist education programs would benefit from knowledge of clinical settings that may present greater challenges and factors contributing to difficulty during CEs. The purposes of this study were to identify the: (1) incidence of SPT difficulty during CEs by practice setting and level of CE; (2) clinical instructor (CI) and SPT characteristics, including gender, ethnicity, and the primary domain of learning in which students experienced difficulty; and (3) CE outcomes for SPTs experiencing difficulty. Methods. In this descriptive, retrospective study, a two-part survey was delivered to the 24 Directors of Clinical Education from the New York-New Jersey Clinical Education Consortium requesting program, student and CI demographics, and details regarding all instances of student difficulty during CEs over three cohorts of students. The survey was validated for face and content validity. Mean values, ranges, and frequencies were calculated to analyze demographic data. Frequency distributions were performed for further descriptive analysis. Results. Ten programs completed the survey, reporting a total of 76 incidents of student difficulty during a CE. The most frequent practice setting with reported difficulty was acute care (34.2%), followed by outpatient (31.6%), with fewer incidents of difficulty in rehabilitation (17%) and pediatric settings (14.5%). Difficulty in acute care was identified across all levels of CE, whereas outpatient and rehabilitation had greater incidents reported in more advanced CEs. Most incidents of difficulty in acute care occurred on the first-level CE and noted primarily in the affective domain. In the outpatient setting, difficulty was reported more frequently during intermediate or final CEs in the cognitive domain. Affective issues were reported across all levels of CE, whereas cognitive concerns were described mostly on intermediate or final CEs. Prior academic difficulty was identified in 34.2% of cases and prior professional behavior concerns in 27.6%. None of the reported incidents in the psychomotor domain led to failure of the CE while 40% of incidents reported in the cognitive and 23.5% in the affective domains resulted in CE failure. Discussion and Conclusions. Evaluation of clinical performance outcomes is critical in physical therapist student education to prepare students for the demands of clinical practice. Knowledge of areas where students most frequently demonstrate difficulty during CEs may allow programs to evaluate and modify curriculum to improve outcomes. The acute care and outpatient settings may be challenging for PT students related to specific domains of learning. Knowledge gained from this study can inform student preparation for various CEs and the related affective and cognitive skills required for clinical success.

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

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

A survey of physiotherapists’ current management and the promotion of physical activity, in people with rheumatoid arthritis

Purpose: Establishing physiotherapists’ management of people with rheumatoid arthritis, in addition to their promotion of physical activity, is important to ascertain if there are educational needs in this area.Materials and methods: Physiotherapists from three Irish Chartered Physiotherapy clinical interest groups (N = 457) were invited to participate in a cross-sectional online questionnaire hosted on SurveyMonkey(R)™.Results: One hundred and sixty-eight (168/457; 37%) responded. Exercise prescription and education were the most frequent treatments, with 84% always/regularly providing same. Physical activity is a component of treatment with 52% always/regularly advising. In addition, 69% agree that physical activity is attainable, 68% safe, and 67% an important goal. However, 62% never recommend the appropriate guidelines, while 14% define physical activity according to frequently used definitions. There was a statistically significant association between longer years qualified and more years working with people with RA, when using guidelines to guide physical activity and exercise prescription. Low-intensity exercises were prescribed by however, 67% never provide high-intensity.Conclusions: Current practice is in line with guidelines in which, exercise therapy and education are considered as the mainstay. Promotion of physical activity is strong; however, two-thirds never recommend the appropriate guidelines, and only a minority defined physical activity correctly. The majority never prescribe high-intensity exercise. There is a need to develop education and training for physiotherapists in the promotion of physical activity in people with rheumatoid arthritis.Implications for rehabilitationExercise therapy and education are considered as the mainstay in the physiotherapy management of people with rheumatoid arthritis.Those physiotherapists’ who are qualified longer and have more experience working with people with rheumatoid arthritis use the relevant physical activity guidelines.Overall there is a need to develop education and training for physiotherapists in the promotion of physical activity in people with rheumatoid arthritis.

Physiotherapy clinical education at a South African university

Background. Clinical education for physiotherapists forms a vital part of undergraduate programmes and equips students with competencies to practise autonomously as qualified health practitioners. However, disparities are evident in approaches to clinical education. Objective. To explore the perceptions of physiotherapy students, community-service physiotherapists and physiotherapy clinical supervisors regarding the clinical education framework at a tertiary institution in South Africa in order to understand preparedness of students for practice. Methods. A case study approach with two focus group discussions with students and interviews with community physiotherapists and clinical supervisors was employed. Data were analysed and categorised into key themes and sub-themes. Results. Five themes emerged from triangulation of data from the three groups: preparedness for professional practice, institutional barriers, curriculum disputes, personal factors and recommendations for physiotherapy clinical education. Students felt inadequately prepared owing to a perceived lack of exposure to certain aspects of physiotherapy, while community therapists believed that reflection on the undergraduate programme after qualifying contributed to their adequate preparation. Clinical supervisors supposed that students would benefit from actively engaging with teaching and learning opportunities, and clinical personnel collaboration was seen as key to facilitate a continuum in clinical education from classroom to healthcare setting. Conclusion. Participants reported that the existing curriculum structure may need to be revisited to address various issues, while holistic collaboration between students, supervisors and clinical personnel is imperative to create a cohesive learning environment.

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

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

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

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