Physical Therapy Faculty Research Articles

Scholarship, Teaching, Service, & Job Satisfaction: Academia’s Balancing Act

Abstract Date Presented 03/21/24 OT and physical therapy faculty transitioning from clinical practice to academia face a new set of tasks. The requirements to make service contributions, to meet teaching load requirements, and to participate in scholarly projects can lead to job dissatisfaction. Primary Author and Speaker: Cody Cox Additional Authors and Speakers: Sara L. Wyckoff Contributing Authors: James Lewis

On Merit and Equity in Admission to US Physical Therapist Education Programs: A Qualitative Analysis of Faculty Habitus

Introduction. In contrast to the increased diversity of the US population, historically excluded racial and ethnic groups remain underrepresented in the physical therapist profession. As decision-makers, faculty exert direct influence on enrollment through evaluating applications and determining which applicants are deserving of admission to physical therapist programs. Review of Literature. Faculty decision-making in admissions is a cultural process which can reproduce inequities and perpetuate underrepresentation if faculty fail to recognize systemic disparities in legitimized forms of merit. No studies within physical therapist education have directly investigated faculty habitus and patterns of thought and behavior which reinforce admissions decision-making. The purpose of this study was to describe patterns of faculty habitus which influence judgments of admission merit and equity in US physical therapist education programs. Subjects. Sixteen physical therapy faculty across 3 physical therapist education programs. Methods. Using interpretative research methodology and a constructivist approach, semistructured interviews were conducted with each participant. Faculty social actions were also observed during field observations. Thematic analysis using Bourdieu's social reproduction theory was used for coding and establishment of themes. Results. Two predominant patterns of faculty habitus with corresponding themes emerged from the data: Transformative habitus oriented faculty toward a sense of responsibility to promote equity, construct a more contextualized understanding of merit, and formulate compelling applicant storylines; gatekeeping habitus positioned faculty to support a meritocratic process, reinforce traditional notions of academic rigor, and support the necessity of adjusting standards to address underrepresentation. Discussion and Conclusion. Findings revealed contrasting patterns of faculty habitus which legitimized certain criteria, knowledge, and experiences on which decisions of merit were based. Attention to the individual dispositions of faculty decision-makers in addition to criteria and processes used in holistic review may shape equitable access to physical therapist education programs.

RESEARCH AND EXTENSION PARTICIPATION OF PHYSICAL THERAPY FACULTY MEMBERS IN THE PRESENCE OF INTRINSIC-EXTRINSIC MOTIVATORS AND RELATED CRITERIA IN PERFORMANCE APPRAISALS

Introduction: The three thrusts of the Commission on Higher Education revolve around instruction, research, and extension. Performance appraisals (PA) have been utilized in various forms in different organizations, with the expected outcome of excellent employee performance. However, despite its utilization in universities, research and extension-related criteria seem to be limited in the appraisals. The study aimed to determine the following: (1) the likelihood of research and extension participation if related criteria are included in the PAs of physical therapy faculty members; (2) the relationship between intrinsic and extrinsic motivation and research or extension participation; (3) factors that are implemented or not by HEIs to enhance faculty engagement. Methods: A mixed method design was utilized, with dominance of quantitative over qualitative data. Seventy-five full-time faculty members of Physical Therapy programs responded to the survey. Data were collected for six months using the Google Form online questionnaire. Spearman Rho and descriptive statistics were used to examine the results. Responses to open-ended questions were manually grouped into categories using thematic analysis. Results: The research showed that physical therapy faculty members are more likely to participate in research and extension activities if related criteria are included in the appraisals. Further, the study revealed a significant relationship between the intent to participate in research and extension-related activities and intrinsic motivation, but it did not indicate an association when correlated with extrinsic motivation. Professional development is a strong intrinsic motivator. Discussion: The inclusion of research and extension-related criteria in performance appraisals and consideration of intrinsic motivators must be considered by academic institutions to encourage faculty members to participate in research and extension activities. The author recommends maximizing the positive effects of performance appraisals by providing clear expectations to faculty members. Furthermore, intrinsic factors may serve as powerful motivators and, therefore, should be thought of to encourage participation. A strong, robust, well-supported policy centered on the organization’s vision, mission, and goals is necessary for successful implementation.

The physical and psychosocial impact of a school-based running programme for adolescents with disabilities.

Adolescents with disabilities have fewer opportunities to participate in community-based fitness programmes. The purpose of this study was to examine the impact of a school-based running programme at a local middle school in Lebanon, Pennsylvania, on fitness and quality of life (QoL) in children with physical and cognitive disabilities in a life-skills classroom. Nineteen adolescents with diagnosed disabilities including intellectual disability (ID), autism spectrum disorder and Down syndrome were recruited from three life-skills classrooms to participate in a school-based running programme. The programme was designed to be implemented two times/week for 6weeks by classroom teachers/aides. Physical therapy faculty and students developed the programme and assisted with implementation. Each session lasted 30min, consisting of a warm-up and cooldown, relay races, games and timed runs. Pre- and post-test measures included physiological cost index (PCI) and Paediatric Quality of Life Inventory™ (PedsQL™). Pre- and post-test data were compared using Wilcoxon signed rank tests. Each week participants also completed a training log to reflect on the activity for the day. Participants demonstrated significant improvements in PCI (P=0.028) and the PedsQL™ (P=0.008) following the running programme. Results of this study suggest that participation in a 6-week school-based running programme may improve fitness and QoL in adolescents with disabilities.

The current state of anatomy education in United States doctor of physical therapy programs.

Physical therapy education has significantly evolved over the past few decades. While gross anatomy is integral to physical therapy education curricula, the current state of anatomy education within these programs is not well understood. The primary purpose of this report was to provide an update on the current state of anatomy education across United States (US) Doctor of Physical Therapy (DPT) programs. A survey was disseminated to all 261 accredited US physical therapy programs. The survey was deployed in November 2020 with a deadline to respond by January 15, 2021. The response rate was 32.6% (85/261). When teaching anatomy, 90.5% of the responding programs used dissection, 71.4% used didactic lectures, 60.7% used computer-assisted technology, 58% used prosections, 23.8% used plastinated models, and 31% reported using other methods. DPT programs have experienced declines in PhD faculty (15.7%) and Master of Physical Therapy faculty (15.3%) and notable increases in DPT (16.5%) and physician faculty (8.2%) teaching anatomy within DPT programs. Despite greater use of computer-assisted technologies, these technologies have not replaced donor-based dissection in DPT programs.

Justice in Educational Content: A Guide to Racial and Cultural Representation in Academic and Clinical Teaching and Assessment.

Case-based instruction is broadly used in health professions education, including physical therapy education. Case-based instruction can support achievement of higher-order, applied, learning objectives and clinical reasoning. Instructors strive to represent the diversity of the clinical population in case studies and may have explicit intercultural competency objectives. The inclusion of cultural, racial, and ethnic characteristics in cases or assessments can potentially reinforce stereotypes or inaccurately emphasize these characteristics as direct predictors of health profile. Furthermore, as most physical therapy faculty creating cases are from a White majority stance, there is a risk that inclusion of cultural elements risks inappropriate and biased representation. Well-intentioned instructors risk substituting cultural, racial, and ethnic characteristics for social and structural determinants of health. Race is a social, not biologic construction and should not be confused. Informed instructors guided by evidence-based strategies can achieve rich case depictions that do not convey inaccurate risk or alienate learners. A curriculum design strategy is offered for case development that brings explicit attention to representation of race and culture. This tool serves as a self-reflective and improvement tool. Continued community and student engagement is necessary to achieve high-quality and instructive case studies.

Students' Perception of Servant Leadership by Physical Therapy Faculty Mentors Is Associated With Interprofessional Socialization.

Promoting interprofessional collaborative practice (IPCP) is necessary. Consequently, investigating strategies associated with increased interprofessional socialization, the beliefs, behaviors, and attitudes underlying socialization toward IPCP is suggested. The purpose of this study was to examine the relationship, in the presence of control variables, between students' perception of servant leadership by physical therapy faculty mentors and interprofessional socialization. Although faculty mentors are associated with influencing students' socialization process and servant leadership is suggested to support collaborative care, investigations exploring these concepts within physical therapy education are limited. Three cohorts of students (60 each) at an entry-level physical therapist education program in the Midwest of the United States. One hundred seventy individuals completed an anonymous paper-based composite survey, with 117 identifying the presence of an informal physical therapy faculty mentor. This cross-sectional survey study, inclusive of student demographic control variables, examined the relationship between interprofessional socialization and perceptions of physical therapy faculty mentors, as measured by the Interprofessional Socialization and Valuing Scale (ISVS-21) and the Servant Leadership Measure (SL-7), respectively. Multiple linear regression was used to obtain the semi-partial correlation (sr) between the SL-7 and the ISVS-21, with significance accepted at P < .05. Upon necessary assumptions being met, 114 participants were included with an analysis of variance identifying the model to be significant (F(8,105) = 2.59, P = .01). Multiple linear regression analysis found that the SL-7, in the presence of control variables, was associated with a significant proportion of ISVS-21 scores (R2 = 0.17, F(8,105) = 2.59, P = .01). Notably, only the SL-7 demonstrated a significant contribution to ISVS-21 estimates (β = 0.358, P < .001), with a significant and positive sr of 0.34 (P < .001). Perceptions of servant leadership by faculty mentors were positively correlated with interprofessional socialization. Findings bolster the theoretical link between servant leadership and interprofessional socialization, servant leadership in the development of faculty and mentorship programs, and the relevance of informal social interactions.

Challenges and Opportunities for Physical Therapist Education Research: Results From an American Council of Academic Physical Therapy Needs Assessment Survey

Introduction. The physical therapy (PT) profession has cited a need for education research, yet the needs of researchers are not fully understood. Furthermore, there continues to be a limited understanding of where resources are most needed to support and advance education research. The purpose of this study was to identify barriers and opportunities for education research to support PT faculty. Review of Literature. Scholarly productivity may be related to the attainment of an academic doctoral degree, research culture within an institution, and faculty time devoted to research. There is a lack of knowledge about what factors relate to the production of education research and the types of support needed for education researchers. Subjects. Two hundred sixteen PT education researchers. Methods. An open survey invitation was sent through email through the American Council of Academic Physical Therapy newsletter. A multiple regression analysis was used to determine factors that were associated with scholarly productivity of education researchers in PT. Open responses to a question regarding needed resources for engagement in education research were qualitatively analyzed. Results. The multiple regression analysis yielded a large effect (R2 = 0.31), demonstrating that faculty years of experience, faculty rank, and having an academic doctoral degree were correlated with scholarly productivity. “Faculty time/workload” was considered “very important” or higher to the production of education research by 87% of respondents. This item was rated of highest importance on the survey. Mentorship was considered the most important external resource, with 69% of respondents rating it as “very important” or higher, whereas “other personal commitments (ie, family care, household management, other community-related volunteer commitments)” was the most important personal factor (rated by 70% of the respondents as “very important” or higher). Open-ended responses further suggest that institution logistics, appropriate dissemination venues, and funding are areas of need to foster success in engaging in education research. Discussion and Conclusion. Results highlight challenges and opportunities for resource investment in education research. Among these are time and funding. Existing professional networking and educational opportunities need to be continually evaluated for their effectiveness. Further development should focus on mitigating these barriers while considering the logistics of the researcher's institution.

The Psychological Impacts of Taking Physiotherapy Teaching Online in 2020: What Did We Learn?

The rapid shift to online learning due to the COVID-19 pandemic presented challenges for physical therapy (PT) education worldwide. This article aims to explore the factors influencing the well-being of the PT faculty and department chairs involved in delivering PT programs during the initial stages of the COVID-19 pandemic. The literature has focused on the pedagogical impacts of the rapid shift to online learning. Little is known about the social and psychological impacts of this rapid transition on the well-being of the faculty involved in implementing PT programs. Physical therapy faculty and department chairs at 3 universities in metropolitan Sydney, Australia who taught into or led PT programs in 2020. Focus group methodology was used to explore the experiences of PT faculty and department chairs during the initial stages of the COVID pandemic. The focus groups were digitally recorded and transcribed verbatim and the transcripts analyzed thematically. The main finding of this study was the extent of stress experienced by PT program faculty and chairs during this period. Both work-related institutional and faculty factors and non-work-related personal factors contributed to perceived high levels of stress. Overall, there was a feeling that the stressors had not improved over the duration of the pandemic and that this had left the faculty and chairs feeling more fatigued, less collegiate, and may have ongoing impacts on their mental health. The pandemic created stresses for faculty and program chairs over and above the usual stress of faculty and college work. The reality of taking steps to reduce the stressors in the current climate is very difficult. Moving forward, it is vital to secure increased institutional support, including the support for creating realistic boundaries without the risk of penalty, to address the psychological health and well-being of PT faculty and chairs to enable high-quality education in the future.

Cannabis Content in Athletic Training and Physical Therapy Curriculums in the United States

Background: Cannabis is the most commonly used illicit drug in the U.S. and its use is becoming more popular with the legalization of medical marijuana. Currently, 36/50 states and the District of Columbia have legalized marijuana for medical purposes. These changes have allowed for more cannabis-related research to be conducted. It is unknown how health professional education programs such as physical therapy and athletic training have integrated cannabis-related curriculum into their students’ training. This study aimed to identify how physical therapy and athletic training education programs are approaching teaching students about cannabis-related topics. Methods: There were 111 individuals from 40 states who responded to the survey (Males=53; Female=58), including 88 athletic training and 23 physical therapy faculty. Methods: An email was sent to all program directors of athletic training and physical therapy programs in the US with a Qualtrics survey link for faculty to complete. The 23-item questionnaire included closed-ended questions on demographics, where they sought cannabis-related information, and whether program curriculum includes cannabis-related topics. Frequencies were computed for sources of cannabis-related information and whether program curriculum includes cannabis-related topics. Results: Sixty (53.5%) participants stated they have not received information or completed any training related to cannabis. Of those receiving information or completing training (n=51), the most common sources of information were live lectures (n=23), peer-reviewed manuscripts (n=24), and social media/news (n=21). Also, 43 (38%) participants noted teaching cannabis-related topics in their curriculum. However, 33 participants reported either not completing training related to cannabis or being self-educated through the current literature. Conclusions: These results suggest program faculty may benefit from formal cannabis education in an effort to adequately integrate the content into curriculums.

Overview of Musculoskeletal Disorders in Undergraduate Students

Background: Musculoskeletal disorders are defined as complaints or disorders that cause discomfort to the musculoskeletal system. During lecture activities, students are mostly in a static posture. Static and repetitive muscle loading when sitting for a long period can cause muscle fatigue due to the accumulation of lactic acid. Besides, it produces discomfort or pain in the musculoskeletal system. The purpose of the research is to describe an overview of musculoskeletal disorders in undergraduate students of the Bachelor and Professional Program of Physical Therapy Faculty of Medicine Udayana University during the lecture.&#x0D; Methods: The method of this research is descriptive-analytic with a cross-sectional, which has been carried out from October to November 2021. This research used a total sampling technique. The participants were undergraduate students of the Bachelor and Professional of Physical Therapy Program, College of Medicine, Universitas Udayana, with a total of 196 participants who met the established criteria. Researchers measured musculoskeletal disorders using a Nordic Body Map (NBM) questionnaire. Analysis of research data using univariate analysis, namely age, gender, body mass index, study period, duration of the study, and musculoskeletal disorders.&#x0D; Results: The results showed that musculoskeletal disorders were mostly complained of by students, namely the waist 61.7%, then the back 59%, followed by complaints in the lower neck 53.6% and upper neck 47.4% while the lowest complaints occurred in the left leg with a percentage of 5.6%.&#x0D; Conclusion: A total of 177 (90.3%) students had musculoskeletal disorders during lectures and 19 (9.7%) did not experience musculoskeletal disorders during lectures, and 94.4% had a low risk of musculoskeletal disorders. The risk of low musculoskeletal disorders can be interpreted as not requiring improvement.

The Clinical Reasoning Assessment Tool for Learning from Standardized Patient Experiences: A Pilot Study

Purpose: Clinical reasoning (CR) is the ability to integrate the knowledge of diagnoses with the use of supporting theories to create effective, client-centered interventions. One means of teaching CR to rehabilitation students is using standardized patient (SP) experiences. The relationship between faculty and student CR ratings after SP experiences has not been researched. The purpose of the study was to determine if there would be correlations between physical therapy (PT) and occupational therapy (OT) student and faculty ratings of CR skills after an SP experience. Method: The Clinical Reasoning Assessment Tool (CRAT) was used by students to self-reflect on their CR performance after an SP experience and compared to their respective faculty ratings. The CRAT includes three subsections: content knowledge, procedural knowledge, and conceptual reasoning, each with a visual analog scale. Correlations between students’ self-assessment of CR and faculty reviews were analyzed using Spearman’s rho correlations. Results: Seventeen PT and seventeen OT students participated. Spearman’s rho correlation coefficients for the PT students and their faculty were: content knowledge (r=.180; p=.488), procedural knowledge (r=.697; p=.002), and conceptual reasoning (r=.258; p=.317). Spearman’s rho correlation coefficients for the OT students and their faculty were: content knowledge (r=.103; p=.693), procedural knowledge (r=.676; p=.003), and conceptual reasoning (r=.505; p=.039). Conclusions: Neither PT nor OT student ratings was a statistically significant correlation in content knowledge ratings in relation to respective faculty ratings. Both PT and OT student procedural knowledge rating correlations with faculty were strong and statistically significant. PT student and faculty ratings were not significantly correlated in conceptual reasoning compared to faculty; however, OT students and faculty ratings were strong, had positive correlations, and were statistically significant. Further research is needed to assess students’ CR development longitudinally across curricula.

Practical Applications of Intangible Ironies: Investor Mispricing of Company Assets on and off Its Balance Sheet

<b>Background and Purpose:</b> The peer-reviewed journal article is the basic unit by which scholarship is defined. Few studies have examined peer-reviewed publication productivity in academic physical therapy programs. In this study, the publication productivity in academic physical therapy programs in the United States and Puerto Rico from 1998 to 2002 was documented, and publication productivity was examined in the context of selected program characteristics. <b>Subjects and Methods:</b> A total of 194 programs listed on the Commission on Accreditation in Physical Therapy Education (CAPTE) Web site in the spring of 2004 were examined. The databases were searched for bibliographic citations of journal articles attributed to particular programs. The program characteristics of faculty size, offering of a research doctorate, and listing in the Carnegie Classification of Institutions of Higher Education (Carnegie Classification) were compared with the number of citations. <b>Results:</b> A total of 169 programs had at least 1 attributed citation, 50.3% of the programs had fewer than 5 citations, and 3% had 44 or more citations. Rankings based on the number of citations changed when adjusted for faculty size. Of the 38 programs offering a research doctoral degree, 16 had 20 or more citations. Five programs with 44 or more citations were all categorized by the Carnegie Classification as doctoral intensive or extensive. <b>Discussion and Conclusion:</b> A few programs had a large number of attributed bibliographic citations, but the majority of programs had limited publication productivity in the 5 years studied. These results may provide a baseline for studying the effectiveness of the relatively new CAPTE standards mandating scholarship by physical therapy faculty over time and the impact of the Doctor of Physical Therapy degree on research in physical therapy.

Accessibility to Telerehabilitation Services for People With Multiple Sclerosis: Analysis of Barriers and Limitations.

In multiple sclerosis (MS), telemedicine improves access to specialized medical care; however, barriers remain, including universal access and effective implementation. Focusing on telerehabilitation, ie, remotely delivered physical therapy, our goal was to identify barriers to telerehabilitation implementation and factors associated with patients completing telerehabilitation physical therapy treatment. Quantitative data included a review of electronic health records of patients with MS treated at the University of California San Francisco Physical Therapy Faculty Practice. We extracted demographic, clinical, and transit-related factors. For patients who scheduled an initial evaluation, we recorded the number of follow-ups, cancellations, completed physical therapy goals, and discharges. Qualitative data included interviews with 3 board-certified neurologic physical therapists and patients' perspectives recorded in the subjective portion of physical therapy notes. We identified 111 patients with at least 1 visit (in-person or telerehabilitation) to physical therapy (82 women; mean ± SD age, 54.2 ± 12.7 years). Patients with no disability (Expanded Disability Status Scale [EDSS] score, 0) were 73% less likely to schedule a follow-up appointment (in-person or telerehabilitation) than those with some disability (EDSS score, >0) (odds ratio, 0.27; 95% CI, 0.09-0.75; P = .012). Neurologic physical therapists identified reduced travel burden and scheduling flexibility as benefits of telerehabilitation vs in-person visits. Barriers to telerehabilitation included low technological literacy, cognitive impairment, and fall risk. Patients described scheduling conflicts and pain/illness as barriers to telerehabilitation. Patients with no disability were least likely to complete physical therapy treatment via telerehabilitation. Although both benefits and barriers to completing physical therapy via telerehabilitation are present, the neurologic physical therapists were supportive of a hybrid model for physical therapy.

Promoting Interprofessional Collaboration Among Pediatric Physical Therapy Students Through Remote Simulation

Interprofessional collaboration must be taught in healthcare curriculum to ready graduates for the clinic, however, limited evidence is available to guide pediatric physical therapy faculty in best practices. This quantitative retrospective pretest-posttest study examined collaborative competency attainment, satisfaction, and self-confidence of 84 Doctor of Physical Therapy students from four campuses of a private university. Students participated in a live, remote simulated learning experience and completed the Student Satisfaction and Self-Confidence in Learning scale and the Interprofessional Collaborative Competencies Attainment Survey–Revised. There was significant improvement in student collaborative competencies after the simulated learning experience and students were satisfied and confident in the learning experience regardless of demographics. Findings support implementation of a remote simulation for the purpose of interprofessional collaboration in pediatric physical therapy education and may relate to other fields. Future research may explore the influence of interdisciplinary, remote simulation interventions on student behavior in the clinic and patient outcomes.

Workplace Bullying and Incivility in Physical Therapist Education Programs

Introduction. Workplace bullying and incivility have been recognized as significant problems in both clinical and academic environments. These negative behaviors can lead to disengagement, stress, and lost productivity. The purposes of this study were to 1) identify predictors of bullying experiences and 2) assess the prevalence of being bullied among faculty and staff working in physical therapist education programs across the United States. Review of Literature. More than one-third of US workers are bullied or have witnessed bullying in the workplace. When these disruptive behaviors occur within the context of physical therapist education, the impact can be detrimental to teaching and learning, clinical practice, and individual well-being. Subjects. Participants included 529 Doctor of Physical Therapy faculty and staff. Methods. Respondents completed the uncivil workplace behavior questionnaire—revised and negative acts questionnaire—revised. Results. Survey results revealed that 32.5% of academic faculty had experienced bullying within the last 6 months. Discussion and Conclusion. The prevalence of bullying and incivility in academic physical therapy programs approaches that of the general workforce in the United States. Physical Therapy education programs must take an active role in preventing, recognizing, and managing uncivil behaviors in the academic environment.

Using Recreation for Rehabilitation Through an Adapted Community Bowling Program During COVID-19: A Pilot Study of Youth Outcomes

Research ObjectivesTo examine the effects of a community bowling program with COVID-19 protocols on quality of life and physical abilities in children with disabilities during the COVID-19 pandemic.DesignResearchers retrospectively examined data collected by the community-based program. Data collection occurred pre and post participation in the community-based bowling program.SettingThe study was conducted in four public bowling facilities within the general community.ParticipantsStudy participants included 34 adolescents and children who participated in a free community-based adapted bowling program.InterventionsChildren and adolescents who participated in the program bowled for one hour, once a week for six to twelve weeks. The duration of the bowling program varied according to the location hosting the program.Main Outcome MeasuresQuality of life was evaluated using the PedsQL: Pediatric Quality of Life Inventory Version 4.0 Parent Report for Children (ages 8 to 12). The PedsQL survey was completed pre- and post-program by the parents of the study participants. Participants also completed a pre- and post-program pinch strength test, a grip strength test, a trunk flexion test, and a shoulder range of motion measure. These tests were administered by physical therapy faculty and occupational therapy students.ResultsThe subjects were thirty-four children and adolescents with various disabilities participating in a community bowling program. Autism Spectrum Disorder (ASD) was the most commonly reported condition among the study participants, present in 14 of 34 children (or 41%). There were significant improvements (p-value=0.01) in bilateral pinch and grip strength. No differences were found in thoraco-lumbar range of motion or shoulder range of motion. Significant improvements were found in quality of life (p-value=0.01) primarily related to social and emotional factors.ConclusionsAdapted bowling had a positive effect on the QoL and physical skills of children/adolescents participating in a community-based program. The program was replicable across sites and there was no difference in outcomes from the newly established programs to the established programs.Author(s) DisclosuresNo conflicts of interest have been identified or reported by any of the researchers participating in this study.

Increasing Functional Measurement Tool Utilization by Acute Physical Therapists

Background: At an acute academic medical center, an electronic medical record (EMR) clarity report revealed that proper documentation of a functional measurement tool during acute physical therapy (PT) initial evaluation and reevaluation sessions occurred only 12% of the time. A formal quality improvement project was initiated to correct this gap in recommended best practice. Objective: To increase utilization and documentation of functional measurement tools in acute PT evaluation and reevaluation sessions from baseline of 12% to 100% based on the APTA recommendations for best standard of care in clinical practice. Methods: This quality improvement project involved acute PT staff and faculty in an academic medical center assessing a gap in best practice. Barriers to best clinical practice were assessed and targeted interventions included education and awareness of baseline performance compared with expectations, streamlining usability of the EMR documentation flowsheet and creating resources to address gaps in knowledge, performance, or access to available functional tools. Data were collected at project initiation, midterm, and after final interventions through manual chart reviews, EMR clarity reports, and a custom PT staff survey. Results: Documentation of functional measurements tools improved from the baseline of 12% to 89.5% after full project interventions. Follow-up survey results indicated that PTs' perception of providing the highest quality of care increased by 29 percentage points, from 71% to 100%. Improved diversity of tool usage was also noted. Of the tools documented, Activity Measure for Post-Acute Care (AMPAC) functional measurement tool was selected 90% of the time at baseline and dropped to 66% post-intervention, allowing for a 24% increase in diversity of tool selection. Conclusions: Accurate discovery of the primary and secondary factors impacting tool use with targeted interventions yielded a 7.5-fold improvement (from 12% to 89.5%) in performance and documentation of functional measurement tools during PT evaluation and reevaluation sessions in the acute care setting. The project also highlighted limitations of education alone in effectively promoting adherence to best practice standards. The increased utilization and documentation of functional measurement tools has improved PT practice in this academic medical center through more objective detection of functional changes across the continuum. It should also promote targeted PT interventions, which should improve PT effectiveness and potentially even impact hospital length of stay.

Commentary on "Experiential Learning in Pediatric Physical Therapist Education: Challenges and Facilitators".

“How could I apply this information?” This study provides context to how pediatric physical therapy faculty infuse experiential learning (EL) into didactic courses. It illuminates the barriers that exist that challenge the implementation of EL. Faculty can use the findings from this study to justify and advocate for resources (eg, time, semester course schedules, financial support, and teaching loads) needed for pediatric EL activities. Invested stakeholders were identified as a key success factor in EL. Faculty should identify engaged partners and maintain a longstanding relationship. Individual families, early intervention providers, daycares, pediatric outpatient clinics, pediatric hospitals, and public and private schools can support the implementation of EL activities. The findings from this study also provide clinicians with strategies to facilitate EL opportunities. Clinic administrators and managers can proactively identify staff willing to collaborate with academic faculty to develop and participate in EL. Clinicians work directly with children, families, and community partners, which positions clinicians as facilitators of reliable and consistent EL opportunities. Clinicians also need to be advocates within their own workplace for their participation in EL. “What should I be mindful about when applying this information?” The data collected for this study centered on faculty and did not include perspectives from other stakeholders. Further exploration of other stakeholders' perspectives beyond faculty could identify additional key factors that are needed to facilitate EL opportunities. Investigation of home and workplace facilitators and barriers experienced by other stakeholders outside the academic environment will provide guidance for faculty to address the needs of all stakeholders. Data were limited to faculty providing low or high EL opportunities and excluded faculty that provided no EL. Sampling those with the greatest barriers to EL may provide further insight into additional barriers to EL. Marisa Birkmeier, PT, DPT, PCS Department of Health, Human Function, and Rehabilitation, The George Washington University, Washington, District of Columbia Allison Elegbe, PT, MSPT, PCS Herndon, Virginia

A group respite pilot project for children with special needs.

Providing ongoing care for a family member or loved one with special needs is challenging. It is estimated that about 21% of the adult population in the United States are providing unpaid care for loved ones at home. Of that group, 5.7% are caring for children with special needs. Special needs can range from developmental delay to the provision of complex medical treatments. Family caregivers take on numerous roles to coordinate activities of daily living, therapies, in-home services, school, and appointments. This is often a great source of stress on family caregivers. Providing the proper support for care to remain at home reduces the disruption to children and families' lives (Carter etal., 2012). A pilot project was developed for children with physical, cognitive, and/or developmental impairment. This project was coordinated by nursing and physical therapy faculty and their students. Parents as well as nursing and physical therapy students benefited mutually. Our preliminary responses from families indicated stress relief from caregiving and benefiting from the ability to talk to other parents in similar circumstances.