Physical Therapist Education Research Articles

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

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

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

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

The Utilization of Interval Throwing Programs in the Physical Therapy Setting: A Cross-Sectional Survey.

Context: Interval throwing programs (ITPs) have long been used in the physical therapy setting to aid in the safe and efficacious return to sport for an overhead athlete. However, the overall utilization and variation of ITPs are unknown in the physical therapy setting leading to potential inconsistencies in treatment paradigms. Objective: To determine if differences in practice patterns exist among active physical therapists of various experience levels with regard to years of experience and advanced certifications. Design: Cross-sectional survey study. Participants: A total of 133 licensed physical therapists consented to participate in an online-based survey. Experience groups were delineated based on years of practice (0-1, 1-5, 6-15, and 15+) and possession of advanced certification. Main Outcome Measures: For ranking-based data, a generalized linear mixed model was repeated across criteria response with a Bonferroni post hoc adjustment for pairwise comparisons made within and between groups (α < .05). For degree-based questions, chi-square analysis was used to compare response frequencies for options provided within each question. Results: A 76.7% response rate was achieved with 102 out of the 133 consenting individuals completed the survey. Significant differences (P < .05) were found with responses to both ranking-based and degree-based questions. However, across all groups, physical therapists agreed that throwing mechanics and customized ITP implementation were important for a successful return to throwing. Conclusions: There are inherent differences in ITP prescription among physical therapists with dissimilar experience levels. The possession of advanced certifications and years of practice seem to play a role in how interval programs are prescribed to overhead-throwing athletes. This study helps to identify differences in current physical therapy approaches toward the later stages of rehabilitation for throwing athletes. Further research should identify areas of improvement in physical therapist education as well as appropriate ITP prescription parameters to optimize care and treatment for this patient population.

Faculty development through simulation-based education in physical therapist education

BackgroundThe use of simulation-based education (SBE) in health professions, such as physical therapy, requires faculty to expand their teaching practice and development. The impact of this teaching on the individual faculty member, and how their teaching process changes or develops, is not fully understood. The purpose of this study was to explore individual physical therapist faculty members’ experience with SBE and how those experiences may have transformed their teaching practice to answer the research questions: How do physical therapist faculty develop through including SBE and are there commonalities among educators?MethodsAn interpretive phenomenological analysis approach was used with a small sample of subjects who participated in three individual semi-structured interviews. Interview questions were created through the lens of transformative learning theory to allow faculty transformations to be uncovered. A two-step thematic coding process was conducted across participants to identify commonalities of faculty experiences with SBE in physical therapist education. Credibility and trustworthiness were achieved through member checking and expert external review. Thematic findings were validated with transcript excerpts and research field notes.ResultsEight physical therapist faculty members (25% male) with a range of 3 to 16 years of incorporating SBE shared their individual experiences. Four common themes related to faculty development were identified across the participants. Themes identified are the following: faculty strengthen their professional identity as physical therapists, faculty are affected by their introduction and training with simulation, faculty develop their interprofessional education through SBE, and faculty experiences with SBE facilitate professional growth.ConclusionPhysical therapist educators had similarities in their experiences with SBE that transformed their teaching practice and professional development. This study provides insight into what physical therapist faculty may experience when adopting SBE.

The status of temporomandibular and cervical spine education in post-professional physical therapy training programs recognized by Member Organizations of IFOMPT: an investigation of didactic and clinical education

ObjectivesThe purpose of this investigation was to establish an international baseline of the quantity of physical therapist education on temporomandibular disorders (TMD) during post-professional Orthopedic Manual Physical Therapy (OMPT) education.MethodsAn electronically distributed survey was sent to programs and data analyzed for trends, including a comparison of TMD and cervical spine disorders education. Current data were compared to pre-existing data from the United States.ResultsFor the current data-set, the Mann-Whitney U test demonstrated statistical significance when comparing TMD and cervical spine disorders education for both the hours of didactic training provided (p < 0.0001) and the number of patients seen during clinical training (p < 0.006). When comparing the United States and international data, statistically significant greater exposure was reported for both didactic (p < 0.0001) and clinical education (p < 0.006) of TMD topics in the United States but not for didactic (p = 0.23) or clinical education (p = 0.15) of cervical spine topics.DiscussionThese data again indicate a lack of uniformity between post-professional training programs in OMPT with respect to TMD education. There is, however, consistency in that most programs provided more training on cervical spine disorders than TMD. Based on these findings, further investigations are appropriate to determine if TMD education is adequate during post-professional OMPT education.

Effects of a Customized Professionalism Educational Intervention on Physical Therapists’ Knowledge and Attributes of Professionalism

Purpose: There is a growing call around the world to include professionalism in the entry-level education of physical therapists and to teach professionalism as a continuing education professional development workshop for practicing physical therapists. Unfortunately, there is currently no empirical evidence to support the use of didactic instruction to effectuate a change in the knowledge and attributes of professionalism. This study evaluated the effects of a customized professionalism educational intervention on physical therapists’ knowledge and attributes of professionalism. Methods: A quasi-experimental research was conducted among 47 Nigerian physical therapists (Mean age = 41 ± 10.1 years). The educational intervention consisted of a 3-hour classroom lecture and five case studies on professionalism. The impact of the intervention was evaluated by a Professionalism Inventory that assesses the level of knowledge and attributes of professionalism - clinical competence, a spirit of inquiry, accountability, autonomy, advocacy, innovation and visionary, collegiality and collaboration, and ethics and value. Results: Post intervention, the physical therapist's aggregate knowledge of professionalism score improved significantly from 69% to 77% performance level (t = 2.340; p &lt; 0.05). On the contrary, there was no significant difference in the aggregate attributes of professionalism score following the intervention (t = 1.396, p &gt; 0.05). Although the improvement observed in the aggregate attributes of professionalism score was not statistically significant, when the effects of the intervention were examined on the attributes of professionalism subscales, the results revealed that clinical competence, accountability, autonomy, innovation and visionary, and collaborating and collegiality improved significantly (p &lt; 0.05). The intervention was of small practical significance (Cohen d = .34 and .20 for knowledge and attributes of professionalism scores, respectively). Conclusions: It was inferred from the findings that a three-hour classroom instruction consisting of lectures and case studies presentation could improve the knowledge of professionalism of practicing physical therapists. A longer instructional period vis-à-vis mentoring and role modelling in the classroom may be needed to effectuate a practical change in professionalism.

National Study of Excellence and Innovation in Physical Therapist Education: Part 2-A Call to Reform.

National Study of Excellence and Innovation in Physical Therapist Education: Part 2-A Call to Reform.

救命救急センターにおける理学療法士の現状調査(A survey study of current physical therapy practices in emergency and critical care center in Japan)

要旨救急部門に専従する理学療法士を配置したうえで教育を行うことが，救急患者への効果的な理学療法に関連しているとの仮説を検証するために，現状調査を行った。対象は，全国の救命救急センター256施設に勤務する理学療法士（各施設1名）とし，アンケート調査用紙を郵送にて配付して回収した。主たる内容は施設背景，理学療法士の配置，理学療法実施状況，専門的教育や多職種連携教育とした。回収率は56%であった。理学療法士の配置形式は，専従配置が7施設（5%），専任配置が12施設（8%），兼任配置が127施設（85%），実施なしが3施設（2%）であった。患者1人あたりの理学療法時間は専従・専任の場合，兼任配置よりも有意に長かった。専従・専任していない最大の理由は人員不足であった。理学療法士は，どの配置形式でも理学療法実施時間について20分間の不足を感じていた。救命救急センターに従事する理学療法士を育成する専門教育の必要性を感じていたのは93%だったが，その教育システムの存在は11%であった。本邦の救命救急センターにおける理学療法士の専従は少なく，兼任配置の場合の理学療法時間や頻度は十分とはいえない。専従・専任配置による効果，適切な理学療法時間，頻度および内容，教育体制や方法について検討する必要がある。

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

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

Linking the Essential Core Competencies to Pediatric Content in an Entry-Level Physical Therapy Education Curriculum: A Case Report

Background and Purpose. In 2012, the Section on Pediatrics (SoP) established five Essential Core Competencies in Entry-Level Pediatric Physical Therapy Education representing the expected pediatric knowledge base, skills, and abilities of all graduating physical therapist (PT) students. To facilitate the integration of the Core Competencies within curricula and to achieve intended academic objectives, educators need tools to connect or “link” specific didactic content to each of the five Core Competencies and their associated subcriteria. The purpose of the current case report was to introduce a novel systematic approach using linking rules to demonstrate comprehensive inclusion of Essential Core Competencies within professional (entry-level) PT education programs. Case Description. Course descriptions and objectives within the curriculum of an accredited entry-level physical therapy professional program were reviewed for pediatric content. Two investigators independently assigned pediatric curriculum content to the 5 Essential Core Competencies using 10 linking rules. A third investigator was used to establish a consensus during the linking process. Frequencies and percentages representing the inclusion of each of the competencies and their associated subcriteria were calculated. Percent agreement and Cohen's kappa (κ) between the two independent investigators were calculated to evaluate the interrater reliability of the linking process. Outcomes. One hundred sixty-five (17%) of the 976 course objectives within the entry-level physical therapy professional program contained pediatric content. All 5 of the Essential Core Competencies were represented at varying degrees: human development (17%), age-appropriate patient/client management (51%), family-centered care for all patient/client and family interactions (6%), health promotion and safety (12%), and legislation, policy, and systems (7%). The remaining objectives (7%) were considered either General Pediatric Content or Not Covered by the Core Competencies, or Not Definable. The linking process had substantial interrater reliability (κ = 0.76; standard error = 0.09; 95% confidence interval = 0.60–0.93) between the two independent investigators. Discussion and Conclusion. A systematic approach to linking pediatric curriculum content to the Essential Core Competencies was introduced and applied using an integrated professional (entry-level) physical therapy education program. Such reliable systematic processes support best educational practice by confirming that all relevant pediatric content is preserved throughout an integrated physical therapy curriculum and ensures that PT students are provided with the essential knowledge base, skills, and abilities needed to successfully work with children. Future research should apply the linking strategies to nonintegrated physical therapy curricula, programs in other geographic regions, and content outside of pediatrics.

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

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

THE MOVEMENT SYSTEM IN EDUCATION

5.

DIAGNOSIS DIALOG: RECAP AND RELEVANCE TO RECENT APTA ACTIONS

For at least 40 years, physical therapists have been contemplating the issue of diagnosis. After the profession chose to require completion of doctoral-level training for entry into the profession, making some decisions about diagnosis became essential. In the 2004 Maley Lecture, Cynthia Coffin-Zadai called the profession to action on the question of diagnosis. One response to her call was the formation of a group of physical therapists from across the country to engage in an extended conversation about diagnosis. The Diagnosis Dialog group first met in St. Louis in 2006 and at the end of the meeting they decided to continue the discussion at another meeting. In fact, they met a total of 13 times over 10 years. The purposes of this article are to a) summarize briefly some of the topics that were discussed and b) demonstrate the relevance of those discussions to recent APTA actions regarding the adoption of the movement system as the core of physical therapist practice, education, and research.

Computer Based Testingを用いた理学療法士・作業療法士教育における基本的知識と問題解決能力に関する評価システムの開発

Computer Based Testingを用いた理学療法士・作業療法士教育における基本的知識と問題解決能力に関する評価システムの開発

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

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

Epistemic beliefs as a determinant in evidence-based practice in physiotherapy – a Multi-Country (Europe) Cross-Sectional Online Survey Study

Purpose: This article assumes that, in order to improve evidence-based practice in physiotherapy, practitioners need sophisticated epistemic beliefs. Epistemic beliefs, or how physiotherapists view knowledge and how they come to this knowledge, are an important factor. A high sophistication of epistemic beliefs is linked to better handling of the complexity and uncertainty of daily practice and the variety of evidence resources associated with this practice.Materials and methods: This study explored the epistemic beliefs of physiotherapists in 10 different countries in Europe using an online survey: the Connotative Aspects of Epistemic Beliefs (CAEB).Results and conclusions: The study resulted in 1419 surveys. The epistemic beliefs proved to be of little difference between countries, showing a low to moderate sophistication in epistemic beliefs. Given the similar results between countries, this study also suggested the possibility of collaborating internationally in developing an epistemology in physiotherapy that is more suited to the complexity of current demands on health systems. The development of sophistication in epistemic beliefs should be firmly on the agenda for the education of physiotherapists.

A Model to Integrate Health Promotion and Wellness in Physical Therapist Practice: Development and Validation.

Globally, physical therapy professional organizations have called for physical therapists to perform lifestyle behavior management during customary care, or health-focused care, due to increasing morbidity and mortality related to noncommunicable diseases. Given the potential for health-focused care to improve health outcomes, physical therapists should integrate health promotion into their daily clinical practice. A clinical model that illustrates necessary steps to deliver health-focused care would be helpful to educate present and future physical therapists. The purpose of the study was to develop and validate the Health-Focused Physical Therapy Model (HFPTM) for physical inactivity and smoking. The authors used a mixed method approach. The preliminary model was informed by previous research and the investigators' shared experience in health promotion and physical therapy. An interdisciplinary group of health professionals provided input into the preliminary model by way of a World Café format. Eight physical therapists with health promotion and education expertise then engaged in a Delphi process to establish content validity. World Café participants indicated that: (1) physical therapists are well positioned to engage in health promotion and wellness, and (2) the model facilitates interdisciplinary collaboration and consultation. Delphi process participants reached majority consensus in 1 round. The average model content validity index (CVI) was .915 for physical inactivity and .899 for smoking. Agreement concerning the model schematic was 88% for either behavior. Investigators made few editorial changes after the Delphi process. Limitations of this study include using only 2 unhealthy lifestyle behaviors for testing, and performing the testing in a nonclinical setting. An interdisciplinary group of health professionals believes that physical therapists should practice health-focused care and that the HFPTM is a valid model. This model could help physical therapist educators when educating physical therapist students and clinicians to practice health-focused care.

Advancing Physical Therapy Practice through Curriculum Revision: The Malawi Experience.

Challenged health systems are a motivation for health education reform. Although resources-limited areas cover our planet, sub-Saharan Africa has the highest disease burden, yet the lowest health-care provider and medical school density of any region in the world. Malawi is among the most under-resourced countries in the world. While much of the data focus on dental, medical, and psychiatric service provision, physical therapists are also in short supply. Among the barriers to achieving the recommended standards for physical therapist education, African physiotherapists (the term for “physical therapists” in Africa) identify limited training opportunities, limited research education, and limited resources and funding. The purpose of this article is to describe an international partnership for strengthening the Malawian physiotherapist workforce capacity through curriculum revision in the Department of Physiotherapy at the University of Malawi’s College of Medicine.

Application of Digital Human Models to Physiotherapy Training

The importance of physiotherapy is becoming more significant with the increasing number of countries with aging populations. Thus, the education of physiotherapists is a crucial concern in many countries. Information and communications technologies, such as motion capture systems, have been introduced to sophisticate the training methods used in physiotherapy. However, the methods employed in most training schools for physiotherapists and occupational therapists remain dependent on more conventional materials. These materials include conventional textbooks with samples of traditional gait motion photographs and video archives of patients' walking motion. Actual on-site clinical training is also utilized in current physiotherapy education programs. The present paper addresses an application of a previously developed digital human model called the kinematic digital human (KDH) to physiotherapy education with a focus on improving students' understanding of the gait motion of disabled patients. KDH models for use in physiotherapy were constructed based on Rancho Los Amigos National Rehabilitation Center (RLANRC) terminology, which is considered the preferred standard among clinicians. The developed KDH models were employed to allow the three-dimensional visualization of the gait motion of a hemiplegic patient.

Virtual Reality and Serious Games in Neurorehabilitation of Children and Adults: Prevention, Plasticity, and Participation.

Use of virtual reality (VR) and serious games (SGs) interventions within rehabilitation as motivating tools for task specific training for individuals with neurological conditions are fast-developing. Within this perspective paper we use the framework of the IV STEP conference to summarize the literature on VR and SG for children and adults by three topics: Prevention; Outcomes: Body-Function-Structure, Activity and Participation; and Plasticity. Overall the literature in this area offers support for use of VR and SGs to improve body functions and to some extent activity domain outcomes. Critical analysis of clients' goals and selective evaluation of VR and SGs are necessary to appropriately take advantage of these tools within intervention. Further research on prevention, participation, and plasticity is warranted. We offer suggestions for bridging the gap between research and practice integrating VR and SGs into physical therapist education and practice.