Professional Physical Therapist Education Programs Research Articles

Burnout, Exhaustion, Experiences of Discrimination, and Stress among Underrepresented and First-Generation College Students in Graduate Health Profession Education.

Mental health disorders are increasing among health profession students. Compounding this, students from underrepresented backgrounds may face additional stressors and challenges. The aims of this study were to: 1) assess the extent to which burnout, exhaustion, experiences of discrimination, and stress exist among students in dentistry, nursing, occupational therapy, pharmacy, and physical therapist professional education programs; 2) determine if there are significant differences by key demographic characteristics (those who are first-generation college students [FGCS], a member of an underrepresented minority [URM] group), or both); and 3) highlight strategies and solutions to alleviate these challenges identified by students. Cross-sectional survey using a mix of question types of a sample of graduate students from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs from February to June 2020. Utilizing the Maslach Burnout Inventory Student Survey (MBI-SS) and campus climate and stress survey, mean subscale scores were calculated for the following outcomes of interest: MBI-SS burnout, dimensions of stress, and observed racism. Logistic regressions examined student factors that may help explain these outcomes. Content analysis examined participants' responses to open-ended questions. There were 611 individuals who completed all survey questions. FGCS were significantly more likely than non-FGCS to report exhaustion (adjusted odds ratio [AOR]: 1.50; 95% CI: 1.04-2.16), family stress (AOR: 3.11; 95% CI: 2.13-4.55), and financial stress (AOR: 1.74; 95% CI: 1.21-2.50). URM students reported not feeling supported in their program and mentioned needing additional support, particularly for well-being, from staff and faculty. Findings from this study are consistent with literature that FGCS students experience additional stressors that may lead to burnout and exhaustion. URM students reported not feeling supported in their programs. This study's findings point to the need for leadership and faculty of health professional schools to implement or strengthen current policies, practices, and strategies that support URM students and FGCS. Research demonstrates that a diverse student body and faculty enhances the educational experience for health professional students, and that diversity strengthens the learning environment and improves learning outcomes, preparing students to care for an increasingly diverse population. However, this study finds that students from underrepresented backgrounds may still experience more burnout, exhaustion, discrimination, and stress than their peers. Programs and policies to support URM students and FGCS throughout their academic careers can help improve graduation and retention rates, leading to improved workforce diversity.

Work-Life Balance of Faculty in Professional Physical Therapist Education: A Mixed-Methods Study.

The purpose of this mixed-methods study was to explore perceptions of work-life balance (WLB) of full-time faculty in professional physical therapist (PT) education programs. Studies show that faculty are at risk of diminution of WLB and subsequent burnout due to job expectations and changing educational landscapes. Limited evidence exists to describe perceived WLB of faculty in professional PT education. Full-time faculty in professional PT education programs (n = 239) responded to an online survey and 16 participated in focus group discussions. The Work/Nonwork Interference and Enhancement Survey (W/NW Scale), faculty characteristic prompts, and open-ended questions were disseminated electronically to all accredited professional PT education programs within the United States. Focus groups were conducted to further explore nuances of WLB. Frequencies and percentages were calculated for survey categorical variables with means and standard deviations for continuous variables. Differences in W/NW Scale and faculty characteristics were analyzed using independent-samples Mann-Whitney U tests. Open coding and an iterative process of thematic analysis was used to analyze the qualitative data. Medians for all W/NW Scale dimensions were between 2 and 3 out of 5. W/NW Scale dimension scores differed significantly in each of the faculty characteristics of gender, defined workload, and faculty job searching (Z = -2.399 to -3.517, P ≤ .016). Qualitative data yielded 3 main themes: 1) implicit and explicit job duties; 2) leadership; and 3) individual boundaries. Ebb and flow of WLB emerged as an overarching theme. This study offers a portrayal of the lived experience of faculty regarding WLB. Results offer useful information about faculty demographics, work-related factors, and personal responsibilities. One limitation was that cultural, community, and religious demands were not explored. Findings may facilitate improved understanding of faculty WLB perceptions and can guide leadership to optimize the balance between faculty's paid work and personal life.

Detecting Artificial Intelligence-Generated Personal Statements in Professional Physical Therapist Education Program Applications: A Lexical Analysis.

The objective of this study was to compare the lexical sophistication of personal statements submitted by professional physical therapist education program applicants with those generated by OpenAI's Chat Generative Pretrained Transformer (ChatGPT). Personal statements from 152 applicants and 20 generated by ChatGPT were collected, all in response to a standardized prompt. These statements were coded numerically, then analyzed with recurrence quantification analyses (RQAs). RQA indices including recurrence, determinism, max line, mean line, and entropy were compared with t-tests. A receiver operating characteristic curve analysis was used to examine discriminative validity of RQA indices to distinguish between ChatGPT and human-generated personal statements. ChatGPT-generated personal statements exhibited higher recurrence, determinism, mean line, and entropy values than did human-generated personal statements. The strongest discriminator was a 13.04% determinism rate, which differentiated ChatGPT from human-generated writing samples with 70% sensitivity and 91.4% specificity (positive likelihood ratio = 8.14). Personal statements with determinism rates exceeding 13% were 8 times more likely to have been ChatGPT than human generated. Although RQA can distinguish artificial intelligence (AI)-generated text from human-generated text, it is not absolute. Thus, AI introduces additional challenges to the authenticity and utility of personal statements. Admissions committees along with organizations providing guidelines in professional physical therapist education program admissions should reevaluate the role of personal statements in applications. As AI-driven chatbots like ChatGPT complicate the evaluation of personal statements, RQA emerges as a potential tool for admissions committees to detect AI-generated statements.

Learning Experiences for Addressing Financial Management Knowledge, Skills, and Attitudes in Entry-Level Physical Therapy Education: A Systematic Review

Background and Purpose. Financial management (FM) knowledge, skills, and attitudes (KSAs) are essential components of contemporary physical therapist (PT) practice. The Commission on Accreditation in Physical Therapy Education requires that FM content is included in professional PT education program (PTEP) curriculums but provides freedom in how the content is delivered. The purpose of this systematic review is to identify learning experiences PTEPs used to educate students regarding FM KSAs that are necessary for entry-level PT practice in the United States. Methods. Articles were eligible for inclusion if they were 1) published in a peer-reviewed scholarly journal, 2) written in English, and 3) described a learning experience used to deliver FM content. Articles describing didactic education, clinical education, or service-learning activities that were a required or voluntary component of professional PTEPs in the United States were included if they reported on objectives or outcomes related to FM. Electronic databases and relevant journals were searched. Search results were subjected to title, abstract, and full-text review. Selected articles were evaluated for methodological rigor. Pertinent data were extracted, analyzed, and synthesized. Results. Eighteen articles were included. Four categories were identified: 1) classroom learning 2) clinical education 3) pro bono clinics, and 4) service learning. Discussion and Conclusion. Student PTs were exposed to FM content in several ways. There was variability in whether participation was required or voluntary, the time commitment required by the student, and the concepts to which students were exposed. There are many opportunities for future research in this area from operationally defining FM, determining necessary FM KSAs for entry-level PTs, and to identifying the most effective learning experiences to ensure that new clinicians are prepared to effectively engage in this aspect of clinical practice.

Simulation-Based Education in Physical Therapist Education: A Survey of Current Practice.

The purposes of this study were to describe the current use of (1) simulation in student physical therapist professional education programs and (2) standards of best practice (SOBP) for simulation-based education (SBE) in physical therapist education. Two surveys were created about current use of SBE in student physical therapist professional education programs in the United States. The first survey contained questions about the program, including the best contact person regarding simulation. The second survey investigated simulation use within the context of SOBP. Survey data were analyzed using descriptive statistics. Survey 1 was sent to the program director at all fully accredited physical therapist programs (N = 236), and 143 responses were returned (61% response rate). Survey 2 was sent to the 136 individuals identified in Survey 1, and we received 81 completed surveys (60%). Over 90% of programs reported including SBE in their curricula, with 86% providing 3 or more experiences. A median of 1 core faculty at each program reported training in SBE, but 23% reported no training. A lack of training in specific elements of the SOBP for SBE was reported by 40% to 50% of faculty. Limited use of SOBP was reported, and use of outcome measures without validation was common. Although SBE is commonly used in physical therapist education, many faculties (1) do not have training in SBE, (2) do not consistently follow the SOBP, and (3) utilize unvalidated outcome measures. Limited faculty training in SBE and inconsistent inclusion of the SOBP suggest student learning in simulation is not optimized. These results show that, despite increased use of simulation in physical therapist education programs, there is a dearth of faculty trained in SBE and inconsistent use of SOBP. Addressing these deficiencies could help to optimize the benefits of SBE in physical therapist education.

Empowering Physical Therapist Professional Education Programs to Deliver Modern Pain Content.

Empowering Physical Therapist Professional Education Programs to Deliver Modern Pain Content.

Stakeholder Assessment of Student Preparedness and Capability to Apply Anatomical Knowledge in Physical Therapy Practice

Introduction & ObjectiveAnatomy is the foundation of clinical practice and great effort has gone into the examination and optimization of its place in professional programs. A thorough literature review revealed a scarcity of information on how well prepared and capable graduates are to apply anatomic knowledge in a clinical setting. For example, medical educators have reported that only 29% of residency directors felt that residents were adequately prepared in gross anatomy, however, the learner themselves felt prepared. The research objective of this work was to examine ratings of preparedness and capability by stakeholders of a physical therapist education program.Materials & MethodsA web‐based survey was developed and distributed to 409 stakeholders of a professional (entry‐level) physical therapist education program. Stakeholders were either a faculty member, recent graduate, or clinical instructor. Clinical anatomy was presented over 16 weeks in the curriculum (ten weeks in Year 1, six weeks in Year 2) and included whole‐body donor dissection. Sections on the survey included demographic information and four Likert‐scale items that addressed the themes of student preparedness in terms of adequate anatomic knowledge and capability to apply that knowledge in a clinical setting. The Kruskal‐Wallis test (ordinal level data) was selected to analyze differences between stakeholder groups.ResultsThe survey was completed by 165 respondents (40% response rate), which represented various levels of experience and post‐professional education (see Table 1). The median overall rating of the four Likert‐scale items was a 4 out of 5 (“quite prepared” and “quite capable”). Statistical analysis revealed significant differences in ratings between stakeholder groups for three survey items, and no significant difference for one item (see Table 2). Recent graduates most often rated students with 4 or 5 (out of 5) on preparedness in terms of adequate anatomical knowledge (P = 0.0477) and capability to explain complex anatomical details to a lay person (P = 0.0003). Faculty least often rated students with 4 or 5 (out of 5) on capability of explaining patient symptoms using underlying anatomy (P = 0.008). Ratings were equivalent for the survey item assessing capability of describing anatomical structures by location.ConclusionOverall, stakeholders reported that physical therapy graduates were prepared with adequate anatomic knowledge and capable of applying it in a clinical setting. There were group differences in the rating of preparedness and capability. Recent graduates rated their preparedness higher than those with more years of experience in the work force (faculty and clinical instructors).Significance & ImplicationThis work presents evidence that students maintain adequate anatomic knowledge and are capable of applying it in a clinical setting upon graduation from the physical therapist education program in this study. It should be noted that these ratings were not uniform across stakeholder groups. These results are important because they represent the opinion of clinicians practicing in the work force.

Impact of Faculty and Programmatic Resources on the Proportion of Academic Doctoral Degrees in Professional Physical Therapist Education Programs.

The Commission on Accreditation in Physical Therapy Education has introduced a requirement that 50% of core faculty members in a physical therapist education program should have an academic doctoral degree, which many programs are not currently meeting. Competition between programs for prestige and resources may explain the discrepancy of academic achievement among faculty despite accreditation standards. The purpose of this study was to identify faculty and program characteristics that are predictive of programs having a higher percentage of faculty with academic doctoral degrees. Yearly accreditation data from 231 programs for a 10-year period were used in a fixed-effects panel analysis. For a 1 percentage point increase in the number of core faculty members, a program could expect a decline in academic doctoral degrees by 14% with all other variables held constant. For a 1% increase in either reported total cost or expenses per student, a program could expect a 7% decline in academic doctoral degrees with all other variables held constant. Programs that have been accredited for a longer period of time could expect to have proportionately more faculty members with academic doctoral degrees. Programs may be increasing their core faculty size to allow faculty with academic doctoral degrees to focus on scholarly productivity. The percentage of faculty with academic doctoral degrees declines as programs increase tuition and expenditures, but this may be due to programs' tendency to stratify individuals (including part-time core faculty) into teaching- and research-focused efforts to maximize their research prowess and status. This study illuminates existing relationships between physical therapist faculty staffing, time spent in research versus teaching, and program finances. The results of this study should be used to inform higher education policy initiatives aimed to lower competitive pressures and the costs of professional education.

Outcomes of 2 Multimodal Human Anatomy Courses Among Doctor of Physical Therapy Students (Entry-Level): A Quasi-experimental Study

Introduction. Alternative methods of anatomy instruction have increased in popularity; however, cadaveric dissections were not consistently reported as the most effective teaching tool. Subjects from 2 professional (entry-level) physical therapist education programs who were taught anatomy using multimodal strategies and either cadaveric dissection or prosected cadavers were compared. The purposes of this study were to 1) determine subjects' approach to learning (surface or deep), 2) determine the preferred learning style of the subjects, 3) assess the subjects' retention of anatomy at the completion of an anatomy course and 6 months later, and 4) determine how much time subjects spent in learning activities for each anatomy pedagogy. Methods. Outcome measures consisted of an anatomy quiz, the Revised 2-Factor Study Process Questionnaire, a Learning Perception Inventory, and the Visual, Auditory, Read/Write, Kinesthetic Questionnaire. Data were collected at 3 points during the study: before anatomy class, immediately at the conclusion of the anatomy class, and 6 months after the class had ended. Data were analyzed using SPSS 25.0 and included descriptive statistics, Wilcoxon signed ranks tests, and Mann–Whitney U tests. Results. Subjects in both programs were kinesthetic learners who used a deep learning approach. Subjects were able to retain anatomical knowledge postanatomy and 6 months after the class ended, no matter which learning tools were used. The group who worked with prosected cadavers perceived spending more total time preparing for anatomy class. Discussion and Conclusion. Based on these results, cadaveric prosection was as effective as cadaveric dissection in 2 multimodal anatomy classes for subjects in 2 professional (entry-level) physical therapist education programs.

Assimilation of the Pediatric Essential Core Competencies by Professional Physical Therapist Education Programs.

This study examined the degree to which pediatric essential core competencies (ECCs) are meeting their intended purpose to provide guidance to pediatric educators in professional physical therapy (PT) education programs and to determine facilitators, barriers, and recommendations to implementation of ECCs in curricula. Pediatric PT educators from professional PT education programs were recruited to participate in a survey. Descriptive statistics were used to analyze close-ended questions for frequency of responses and content analysis to generate themes. Of the 162 completed surveys, most participants were aware of the ECCs (96%) and used them to inform pediatric curriculum (88%). A mean proportion (86%-95%) of participants perceived their program curricula addressed the ECCs very or moderately well. Multiple themes of facilitators/barriers/recommendations to ECC implementation were determined. Most pediatric educators are aware of and using the ECCs to guide pediatric education to prepare graduates for pediatric patients/clients.

A Survey of Physical Therapist Education: Relationships Among Pediatric Curriculum Delivery, Faculty, and Clinical Education

Introduction. This study is a secondary analysis of a 2014 survey study exploring pediatric clinical education in professional physical therapist (PT) education and describes PT education programs within the United States with respect to (1) how the pediatric curricular content is delivered; (2) the characteristics of the individual primarily responsible for delivering the pediatric content; (3) the relationship between characteristics of the individual primarily responsible for delivering the pediatric content and a program's report of sufficient numbers and variety of pediatric clinical education sites; and (4) the relationship between the type of pediatric curricular design used by a program and the program's report of sufficient numbers and variety of pediatric clinical education sites. Methods. A single Director of Clinical Education/Academic Coordinator of Clinical Education from 159 accredited professional PT programs completed the survey. Survey questions in this secondary analysis of the 2014 survey study pertain to the delivery of the pediatric content, characteristics of faculty, and pediatric clinical education experiences. Cross tabulations were used to examine possible relationships. Results. Ninety-nine (62.3%) responding programs reported delivery of the pediatric content through a single stand-alone course. One hundred and twelve (70.4%) responding programs reported that the pediatric content was delivered by a core faculty member with pediatric clinical experience. No significant relationships were found between a report of sufficient numbers and variety of pediatric clinical education sites and either characteristics of individuals delivering the pediatric curricular content or the type of pediatric curricular design used by a program. Discussion and Conclusion. Delivery methods for the pediatric curricular content are variable. Characteristics of the individual delivering this pediatric content are mixed.

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

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

A Forward Move: Interfacing Biotechnology and Physical Therapy In and Out of the Classroom.

Ongoing advances and discoveries in biotechnology will require physical therapists to stay informed and contribute to their development and implementation. The extent of our profession's involvement in how physical therapists engage biotechnology is determined by us. In this Perspective article, we advocate the need for our profession to educate clinicians alongside scientists, technologists, and engineers and empower them to collectively think more as codevelopers and less as "siloed" builders and consumers of biotechnology. In particular, we highlight the value of augmenting the physical therapy curricula to provide students with new levels of knowledge about the converging fields of engineering and physical therapy. We present successful examples of how such a concept can occur within physical therapist professional education programs and propose strategies to overcome perceived challenges that may stymie this possibility.

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

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

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.

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.

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.

Student and Examiner Perceptions of an Innovative Model for Assessment of Neuromuscular Clinical Competence in a Professional Physical Therapist Education Program

Background and Purpose. Assessment of clinical skills is required in physical therapist (PT) education. It can be labor and cost intensive, and put significant demand on faculty time and resources. Currently there is no standard protocol for assessing clinical performance in the didactic portion of a physical therapy curriculum. The purposes of this study are to present an innovative model for assessment of the clinical competence of PT students managing patients with neurologic conditions that is time, labor, and cost effective, and to explore the perceptions of PT students and examiners relating to the innovative model. Participants. Seventy second-year PT students and 11 faculty/clinician examiners participated in this project. Methods/Model Description and Evaluation. A novel format for assessing clinical skills was developed and implemented over a 2-year period in a professional PT education program. Students acted as standardized patients and faculty/clinicians assessed 2 students performing the competency simultaneously. Perceptions of both PT students and examiners were explored using surveys. Data from the surveys were examined and presented. Total cost of the innovative model was calculated and compared to prior competency formats. Outcomes. Two cohorts of PT students and examiners completed the surveys. Student response rate ranged from 70% to 71%, and examiner response rate was 80%. Student responses were largely positive, particularly on questions relating to learning and stress reduction. Examiner responses were largely positive regarding the effectiveness of the innovative model. Significant cost and time reductions were achieved. The number of personnel hours was reduced to 36, representing a 50% reduction. Time was reduced by 50% and cost was reduced by 66%. Discussion and Conclusion. Students found the actor role beneficial to learning and to the development of empathy for future patients. Students being assessed found the experience less stressful, yet still felt that the competency effectively assessed their skills and clinical decision making. Examiners similarly found the innovative model of assessment of clinical skills effective. The reduction in time, cost, and labor demands could greatly benefit programs with large class sizes and small programs with fewer faculty. While satisfactory, this model warrants further development, and exploration of its validity for predicting success on clinical internships.

Educating Physical Therapists in Women's Health: Recommendations for Professional (Entry-Level) and Postprofessional Curricula

Background and Purpose. Managing conditions unique to and more prevalent in women is an emerging trend in care. The key purposes of this study were to determine (1) practice patterns and emphasis of physical therapists, (2) how and to what extent physical therapists were educated about health, ( 3) curricular content deemed important in preparing practicing and professional (entry-level) physical therapists, and (4) by what means therapists may be interested in furthering their knowledge of health. Subjects and Methods. Subjects were a random sample (N = 1,021) of members of the Section on Women's Health of the American Physical Therapy Association who completed a survey on their practice emphasis, educational preparation in health, and opinions regarding content that should be taught at the professional and postprofessional levels in physical therapist education programs. Results. Thirty-seven percent of the subjects (n=347), representing 48 states, responded. A majority of respondents (n=204) reported that up to 25% of their practice involved treating specific issues and most had received minimal academic education specific to health. Examples of curricular content recommended for entry into the profession included osteoporosis, musculoskeletal conditions, obstetrics, and urogenital concerns, while pathology, pelvic floor assessment/treatment, endocrinology, and gynecology were recommended for the postprofessional level. Of the 347 who responded, practitioners' preference for postprofessional education was via continuing education (n=229) or certificate programs (n=227). Discussion and Conclusion. As physical therapist education program curricula evolve in response to degree advances and changes in care policy, educators can use this information to strengthen both professional and postprofessional curricula in health. Key Words: Women's health, Physical therapist education, Curriculum. INTRODUCTION Women's has become a national focus influencing everything from National Institutes of Health policy1 to nutrition options and vitamin supplements. Despite this interest, topics have been reported to be underrepresented in both professional and postprofessional physical therapist education programs.2,3 In 1979, Frahm wrote exposure to the OB/GYN area is noticeably sparse in the American physical therapy school curriculum.4 And now, over 25 years later, there is some question about the degree to which topics are being taught in physical therapist education programs today. According to A Normative Model of Physical Therapist Professional Education, professional physical therapist education programs should graduate students who are sensitive to individual and cultural differences when engaged in physical therapy practice, research, and education.5 To effectively compare the effects of sex on diagnosis, prognosis, health, and wellness, physical therapist education needs to expand the traditional medical view of women's health which typically includes reproductive issues in adolescent girls and adult women.6,7 Instead, physical therapist educators should take steps to account for the broad spectrum of concerns throughout the lifespan and the relative differences between men and women in terms of behaviors, morbidity, disability, and mortality. Additional considerations may also need to be made regarding the demographic, social, cultural, and political influences on a woman's and her approach to care.7-11 Unfortunately, there is little evidence on the current status of content in physical therapy curricula. Therefore, the current study was developed to address the following purposes: (1) to determine practice patterns and practice emphasis of a national sample of physical therapists, (2) to determine how and to what extent these physical therapists were educated about issues, (3) to identify important curricular topics in preparing both practicing (postprofessional) and professional (entry-level) physical therapists to address care needs unique to women, and (4) to determine whether, and by what means, physical therapists were interested in advancing their knowledge of health. …

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.