Journal, physical therapy education最新文献

Introduction: Entry-level Doctor of Physical Therapy (DPT) graduates are not demographically diverse compared with the population of the United States. The curriculum must provide depth, breadth, and opportunity to develop culturally competent providers. The purpose of this qualitative study was to examine perceptions of novice/advanced beginner and experienced physical therapists (PTs) as to how well prepared they felt by their PT education to act as culturally competent providers and compare methods of cultural competence education received. Findings can inform whether cultural competence curriculum standards in PT education are viewed as effective or if changes to curriculum may be needed.

Review of literature: Research has highlighted measured or perceived changes in perceptions, attitudes, and behaviors of cultural competence with clinical exposure and experience for PT students. Studies that examine or compare practicing PT perceptions of the effectiveness of entry-level cultural competence education are limited, as is evidence supporting specific cultural competence curriculum methodology.

Subjects: Thirteen licensed PTs participated in the study.

Methods: In this phenomenological qualitative study, subjects participated in semi-structured interviews. Data were coded and analyzed using a constant comparative approach.

Results: Three themes emerged: 1) clinical practice and life experiences had greater influence on perceptions of preparedness, 2) suggestions to improve cultural competence curriculum, and 3) experiential learning was valued and contributed to culturally competent practice.

Discussion and conclusion: Entry-level DPT programs may consider exposing students to diverse patient populations through diverse clinical rotation opportunities, community outreach, and interactive learning early in the curriculum. Incorporating student experiences with different social, cultural, or ethnic groups may promote a greater perceived value of cultural competence curriculum and improve PTs' perceptions of preparedness to practice culturally competent care. Programs may also examine the direct and indirect influence clinical instructors have on developing DPT students' cultural competence during clinical rotations.

Introduction: The COVID-19 pandemic saw physical therapist (PT) education programs in 2020 add virtual options to prepare students for hands-on clinical skills. The purpose of this research was to investigate student confidence, preparation, and clinical performance based on their choice of virtual or in-person laboratory immersion. Secondary analysis compared 2020 cohort outcomes with the previous cohort in 2019 (prepandemic).

Review of literature: Virtual skill acquisition has been studied with support for effectiveness in didactic and psychomotor skill acquisition. The impact on clinical education performance is unknown.

Subjects: Student records from an accelerated hybrid, PT education program in 2020 (n = 91) and 2019 (n = 86).

Methods: In this mixed-method observational study, researchers analyzed a Qualtrics survey and the PT Clinical Performance Instrument (CPI) to compare student outcomes. Statistical analyses included chi-square, two-way multivariate analysis of variance (MANOVA), and Mann-Whitney U test. MAXQDA software was used to code student and clinical instructor narrative responses from the CPI related to strengths and areas for further development.

Results: All students in 2020 attended laboratory virtually for 9 full days, and 24% of students chose virtual laboratory for the remaining 8.5 days; 97% of students reported feeling confident going into their clinical experience (66% inpatient). No statistically significant differences were found based on instructional method (virtual or in-person) or clinical practice setting (inpatient or outpatient) for confidence, preparation, or CPI performance. Themes of wanting more time to prepare and more confidence in clinical decision making emerged from the qualitative analysis.

Discussion and conclusion: Results indicate no statistically significant difference for virtual versus in-person laboratory and no difference compared with the 2019 cohort. Virtual instruction effectively prepared students for their clinical experiences across all settings. Although an in-person laboratory experience may be preferred, it is possible to deliver effective experiences in a virtual setting without compromising student performance. Further research is needed to confirm findings.

Introduction: Physical therapist (PT) students learn through clinical practice with the supervision of a clinical instructor (CI). Clinical instructors have teaching, education, and practice experiences that can positively affect their self-assessed clinical teaching effectiveness (CTE), which may improve learning outcomes for students.

Review of literature: Identifying CI experiences, such as specific teaching, education, or practice expertise, as they relate to effective clinical teaching may be beneficial in the selection of PT CIs and allow instructors to focus on professional experiences that will elevate their self-assessed teaching abilities.

Subjects: The study included 851 PTs from a large geographical area. The participants had varying educational, clinical, and professional experiences and each had been a CI for at least 1 student clinical education experience.

Methods: Specific PT CI professional experiences associated with CTE were determined through a correlation study using quantitative data collected online through a validated survey instrument, the Clinical Teaching Effectiveness Questionnaire. This study examined degree earned, PT residency and PT fellowship training, the American Board of Physical Therapy Specialties (ABPTS), American Physical Therapy Association (APTA) Credentialed Clinical Instructor Program (CCIP) level 1 and level 2, years of clinical experience, number of students taught, and number of years of clinical teaching.

Results: Results indicated that a higher level of self-assessed CTE was associated with ABPTS certification, CCIP level 1 and level 2, and a higher number of students mentored by a CI. Physical therapist residency training, PT fellowship training, years of clinical experience, and number of years of clinical teaching were not related to self-assessed CTE.

Discussion and conclusion: Specific teaching, clinical, and practice experiences were related to CTE. To increase PT CI CTE, CIs are encouraged to consider ABPTS certification, CCIP level 1 and level 2, and mentoring students regularly. The PT profession, APTA, and Doctor of Physical Therapy programs should support these endeavors.

Introduction: Determining why physical therapists choose certain pathways to expertise is not well understood. Developing an understanding of these different choices is important for the physical therapy profession and the future of postprofessional education.

Review of literature: Pathways to expertise as a physical therapist have evolved over the history of the profession, including the most recent emergence of residency education. Regardless of the path taken, physical therapists have a societal duty to be lifelong learners. The decision on which path to pursue is influenced by many factors, including financial stress, personal factors, and relational obligations. Developing an understanding of these different pathways and barriers for physical therapists is essential if the physical therapy profession is to advance with the evolving needs of society.

Subjects: Participants were from a stratified purposive sample of Doctor of Physical Therapy Students (n = 124) across the eastern, central, and western regions of the United States.

Methods: This study was a secondary analysis using hierarchical cluster analysis based on students' orientation toward lifelong learning and future professional engagement, self-rated likelihood of pursuing various postprofessional education pathways, and perception of personal and interpersonal strains as a barrier to postprofessional education.

Results: The cluster analysis resulted in a 4-cluster solution representing different student subtypes: clinically oriented average learners; resilient, clinically oriented lifelong learners; academically oriented lifelong learners; and strain-limited, clinically oriented lifelong learners.

Discussion and conclusion: Results from this study describe important differences in how student physical therapists view postprofessional education and the pathways they choose to pursue. Factors such as lack of awareness and the perception of personal or interpersonal strain may influence these decisions. Understanding postprofessional education decision making of student physical therapists is of particular interest to the physical therapy profession given the current debates related to student debt and the necessity of residency education. Further research is needed to understand how to increase awareness and diminish barriers to quality postprofessional education for physical therapists.

Background and purpose: Teaching evidence-based practice (EBP) has become a standard curricular goal for Doctor of Physical Therapy (DPT) education programs. In 2014, the American Physical Therapy Association published a consensus document to provide guidance on curricular objectives for teaching EBP in entry-level DPT programs. The document reinforced the need to promote skills related to the efficient and critical consumption of published evidence. The purpose of this case report is to describe the collaborative process of integrating the EBP guidelines in one university's DPT curriculum.

Case description: Faculty of EBP courses, in collaboration with a health sciences librarian, worked collaboratively to review and redesign the courses that teach and promote the skills required for an efficient EBP entry-level clinician, using the EBP guidelines as a reference document. Integrating the guidelines, specifically the five steps of teaching EBP, required creating a curricular thread for both the didactic and the clinical portions of the program, the development of standardized tools to optimize the students' learning, promotion of literature search and appraisal skills, and designing instructional activities, assignments, and standardized rubrics.

Outcomes: The effectiveness of the curricular integration process was evaluated using students' self-efficacy with the acquired EBP skills. Data indicated students who participated in the modified curriculum perceived to have achieved all terminal objectives for each of the EBP steps.

Discussion: This case study highlights the benefits of progressive and early exposure to EBP to facilitate integration into clinical practice. Additionally, it reinforced the idea of EBP as a learnable skill that requires practice and experiential learning.

Conclusion: It is feasible to successfully integrate EBP guidelines into a physical therapist program.

Introduction: 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.

Review of literature: 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.

Subjects: Physical therapy faculty and department chairs at 3 universities in metropolitan Sydney, Australia who taught into or led PT programs in 2020.

Methods: 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.

Results: 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.

Discussion: 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.

Conclusion: 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.

Introduction: National Physical Therapy Exam (NPTE) performance is predicted to some degree by cognitive measures, such as grade point average (GPA) and the Graduate Record Exam scores. Researchers have begun to explore noncognitive measures, for example, grit and mindset, which could account for other potential determinants of student success in physical therapist (PT) education programs and the NPTE.

Review of literature: There is a paucity of evidence that has explored non-cognitive factors related to academic performance compared to cognitive factors. Constructs such as grit and mindset have been identified as reliable measures; however, mixed results occur in the literature as how these scales predict NPTE performance. Cognitive factors continue to demonstrate stronger correlations to NPTE performance.

Subjects: Four PT student cohorts (n = 43, 45, 50, and 49) were enrolled in a prospective cohort study.

Methods: Grit and mindset were measured by self-reported questionnaires. Cognitive measures were obtained, including undergraduate cumulative GPA (cGPA), undergraduate science GPA (sGPA), graduate GPA (gGPA), Academic Practice Exam and Assessment Tool (Academic PEAT) scores, and NPTE scores. Pairwise Pearson's correlation coefficients were calculated for each cohort. National Physical Therapy Exam scores from 2 graduating cohorts were analyzed using multiple linear regression to identify variables that predicted successful outcomes.

Results: Neither grit nor mindset correlated with any cognitive measures. Furthermore, neither grit nor mindset were significantly associated with NPTE scores or outcomes in multivariate regression models. National Physical Therapy Exam scores were significantly associated with gGPA (β = 148.4, 95% confidence interval [CI] = 93.4-203.5) and Academic PEAT scores (β = 0.28, 95% CI = 0.08-0.49).

Discussion and conclusion: Among PT students at a small liberal arts institution in the midwest, grit and mindset were not associated with any indicators of academic success (e.g., cGPA, sGPA, gGPA, Academic PEAT, or NPTE scores). NPTE outcomes were best predicted by gGPA and Academic PEAT scores. These findings conflict with previous reports that grit and mindset are potential markers for academic success and support monitoring gGPA and Academic PEAT scores to identify students who may require additional preparation before sitting for the NPTE.

Introduction: The roles and responsibilities of the director of clinical education (DCE) are of interest in the academic physical therapist (PT) community. This study explored the impact of professional and positional task characteristics of the DCE position on task-fit misalignment within PT education programs. Task-fit explores how the tasks of a particular job align with the appropriately trained person who holds the position.

Review of the literature: A recently published DCE Matrix highlights 2 extremes of misalignment and nonoptimal task-fit between the position and the person. Misalignment was investigated rather than alignment because negative connotations often have greater impact on behavior, decision making, and relationships. The impact of misalignment is unknown.

Subjects: Program directors and DCEs among ACAPT member PT programs were surveyed.

Methods: A qualitative grounded theory design was used. Two rounds of surveys with focused questions about the impact of task-fit misalignment. Qualitative content data analysis through a constant comparative process was followed. Respondent descriptive statistics were collected.

Results: Three realms of impact were identified when misalignment of positional and professional characteristics exists. The realms include the 1) individual person holding the position; 2) academic program; or 3) physical therapy profession. There is a high level of agreement that task-fit misalignment affects each realm; variability exists about its prevalence.

Discussion: There seems to be an interconnectedness of impact among the person, the program, and the profession when misalignment exists between the fit of the DCE to the job or the work environment to the DCE. Findings indicate job crafting may be necessary to evolve the nature of the DCE work toward higher director-level tasks. This is the first study of its kind to explore the impact intersection of person-job fit and task-fit and the impact on a DCE's responsibilities. Nonrespondent or attrition bias may have limited sample size.

Introduction: In physical rehabilitation, motivational interviewing (MI) can improve treatment adherence and therapeutic outcomes. The objective of this study was to investigate the relationship between MI education and use of MI skills in physical therapy practice in the United States.

Review of literature: Motivational interviewing is an empirically supported technique for facilitating behavior change. Numerous studies have examined its use in physical rehabilitation settings. No research has examined education and utilization of MI in physical therapy in the United States.

Subjects: Physical therapists (PTs) in the United States (N = 785) responded to an electronic survey distributed through the special interest academies and state chapters of the American Physical Therapy Association.

Methods: Descriptive, correlational, and group comparisons were used to analyze the survey responses about MI utilization in clinical practice, characteristics of MI training, and self-reported use of MI communication skills.

Results: Two-thirds of the sample reported using MI and half of the sample received training in MI. Motivational interviewing training was heterogeneous, with interactive elements superior to lecture alone. Interestingly, training received in PT education programs correlated negatively with the use of the MI skills assessed in this study. Use of MI skills significantly correlated with increased perceived patient adherence and decreased struggle with patients.

Discussion and conclusion: Incorporation of MI into physical therapy practice has the potential to improve patient care through increased therapeutic rapport, improvement of health outcomes associated with behavior change, and improved job satisfaction. Although MI is becoming more prevalent in physical therapy practice in the United States, the results of this study suggest that MI education should include dynamic components to increase the effective use of MI skills in clinical practice.