Demonstrating Teaching Expertise to Achieve Professional Goals No abstract available

Improving Interprofessional Communication Confidence Among Physical Therapy and Nurse Practitioner Students Introduction. Educators identified a deficiency in interprofessional communication education in a midwestern university's Doctor of Physical Therapy (DPT) and Doctor of Nursing Practice (DNP) programs. While several professional organizations stress the importance of interprofessional communication, few studies have focused on such communication between DPT and DNP students. The purpose of this study was to assess DNP and DPT students' knowledge and perception of confidence in interprofessional communication after a simulation-based learning activity conducted via telephone consultation. During the activity, students used the Situation, Background, Assessment, Recommendation (SBAR) method with a clinical case study. Methods. The study used a nonrandom sample of 52 first-year DPT and 19 second-year DNP students. Participants completed a questionnaire prior to an educational intervention consisting of SBAR and interprofessional education (IPE) modules. The activity was conducted using an online audio conferencing tool. Students then completed a postintervention questionnaire and reflective questions. Results. Data analysis (descriptive statistics, analysis of variance with change scores, and qualitative data analysis) showed that DPT students had significantly higher changes in SBAR combined knowledge and attitude scores compared to DNP students after simulation activity. Discussion and Conclusion. Introducing interprofessional communication such as SBAR approach in DPT and DNP curricula using realistic, simulation-based learning activities with clinical case studies may help students improve their confidence in interprofessional communication.

Improvements in Students' Attitudes Toward People With Disabilities With or Without Semi-Structured Community-Based Interactions Introduction. Repeated interactions with people with disabilities (PWD) in a Doctor of Physical Therapy (DPT) program could improve students' attitudes toward PWD. This study's purposes were to explore if: 1) a baseline first-year DPT curriculum improved DPT students' attitudes toward PWD; 2) an enhanced first-year DPT curriculum improved DPT students' attitudes toward PWD; and 3) there was a difference between the baseline and the enhanced DPT curriculum related to improving DPT students' attitudes toward PWD. Methods. Sixty-four students from 2 DPT cohorts participated in this study. The Attitudes Toward Disabled People (ATDP-A) and Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS) were used. The authors compared the scores of 2 DPT cohorts: 1) a baseline group; and 2) an enhanced curriculum group that had repeated community-based interactions with PWD. Results. The baseline group only had improved attitudes according to the MAS (P = .02), whereas the enhanced group demonstrated improvements with bothATDP-A (P = .01) and MAS (P = .01). No significant difference in scores on the ATDP-A (P = .11) and MAS (P = .38) between the baseline and the enhanced curriculum cohort was found. Discussion and Conclusion. Regardless of being exposed to the baseline or the enhanced curriculum, DPT students' attitudes toward PWD improved. The baseline group showed improvements according to 1 scale, whereas the enhanced group demonstrated improvements with both scales. Perhaps longer or more frequent interactions with PWD may have produced a difference between the baseline and enhanced groups. Although future research is necessary, this study offers ideas on how to incorporate community-based interactions with PWD in a DPT curriculum.

Academic Ethos in Physical Therapy Education Background and Purpose. Academic ethos is the character or virtuousness of the academic institution and its programs that drives scholastic accomplishments. Ethos is obscure yet real and contains emotional energy or passion that gives meaning and moral worth to universities, colleges and academic health centers in contributing to the public good. Little information on academic ethos exists in the higher education literature, likely because it is an elusive concept that does not lend itself to a precise definition. The purpose of this paper is to describe the importance of academic ethos in physical therapy's role in the enterprise of higher education. Position and Rationale. Emphasis includes the responsibilities academic ethos imposes upon academics for being vigilant on matters of character/virtuousness to sustain higher education's noble mission of promoting the public good. Also, threats intrinsic and extrinsic to the academy that weaken academic ethos are described in the form of diminished commitment to intellectualism, corporatization of higher education, political forces, and Faustian bargaining. Discussion and Conclusion. Reflecting on academic ethos will assist physical therapy faculty in congealing their own programmatic ethos, as well as contributing to their institution's ethos, thus enabling them to optimize their role in the academy in serving the public good.

Educational and Experiential Factors Associated With Physical Therapists' Diagnostic Reasoning Introduction. The influence of education level, post-professional training, and experience on physical therapists' (PTs) diagnostic reasoning is unknown. The purpose of this study was to examine the influence of education, training, and experience on PTs' diagnostic reasoning through a series of musculoskeletal case-based surveys. While literature supports quality of care's influence on health care costs, the factors influencing PTs' quality of care are unclear. Literature suggests that surgeons with post-professional training and more experienced Emergency Room physicians demonstrate better patient outcomes, diagnostic accuracy, and efficiency. Methods. Five hundred and twenty-nine licensed PTs participated in this study. A series of 5 case-based electronic surveys assessed participants' diagnostic reasoning in orthopedic presentations. Response rates ranged from 55% to 40%. Accuracy, efficiency, and hypothesis-generation strategies were analyzed to examine diagnostic reasoning. Strength of associations, diagnostic accuracy, and hypothesis-generation strategies were examined via odds ratios; efficiency of determining the accurate diagnosis was examined via t tests. Results. Hypothetico-deductive reasoning by systematically eliminating competing diagnoses (funneling) demonstrated significant correlation with accuracy in 4 of the 5 cases (odds ratio [OR] 2.46 [1.19–5.10] to 13.9 [6.12–31.5]). Physical therapists with any American Board of Physical Therapy Specialities (ABPTS) certification demonstrated significantly greater diagnostic accuracy (OR 2.1 [1.41–3.807] to 3.00 [1.22–7.36]) and efficiency (P < .05) in 3 of the 5 cases compared to those without ABPTS certification. Board-Certified Orthopedic Clinical Specialists (OCS) demonstrated significantly greater diagnostic accuracy (OR 1.90 [1.08–3.34] to 3.42 [1.42–8.40]) and efficiency (P < .05) compared to those without ABPTS OCS certification. Residency-trained PTs demonstrated significantly greater diagnostic accuracy (OR 2.02 [1.03–3.96] to 2.84 [1.38–5.82]) and efficiency (P < .05) compared to those without residency training. Degree level, experience, and fellowship training were not related to accuracy, efficiency, or funneling hypotheses (P > .05). Discussion and Conclusion. American Board of Physical Therapy Specialities certification and American Board of Physical Therapy Residency and Fellowship Education training's significant association with both diagnostic accuracy and efficiency suggests the importance of PTs' pursuit of ABPTS certification and/or formal post-professional training in developing diagnostic reasoning and expertise. These post-professional endeavors may lead to appropriate care more quickly, improving patient outcomes, and decreasing health care costs.

Impact on Clinical Performance of Required Participation in a Student-Run Pro Bono Clinic Background and Purpose. Early opportunities for students to develop clinical skills and professional attributes are important to maximize clinical learning. Student-run pro bono clinics have the potential to provide early contextual exposure. This article describes the impact of required compared to voluntary participation in a student-run pro bono clinic on clinical performance during the first full-time internship. Method/Model Description and Evaluation. Students in the University of Florida Doctor of Physical Therapy program were assigned to one of four service learning groups including a pro bono clinic. While attendance at the clinic was encouraged for all students, only the assigned group was required to attend twice a semester. A retrospective analysis of student performance on the Clinical Performance Instrument (CPI) for the first internship was conducted. Clinician CPI ratings were categorized as beginner or intermediate and above. Median scores for safety, professional practice, and practice management items for those students who were required to attend the clinic were compared to students from the other service learning groups who did not attend or attended voluntarily using Chi-square analysis. Outcomes. At midterm, a higher proportion of the required pro bono group were rated as intermediate or above by clinical instructors for safety, all professional practice items except professional development, and all patient management items except diagnosis/prognosis, education, and consideration of financial resources. Differences were present at the final evaluation for safety, professional behavior, cultural competence, clinical reasoning, and examination. Discussion and Conclusion. Positive outcomes were present for students involved in the pro bono clinic, illustrating the potential benefits of required pro bono clinic experiences early in a professional curriculum for accelerating clinical performance.

Evaluation of a Long-Term, Physical Therapy Service-Learning Partnership in Ecuador: Inclusion of the Community Voice Background and Purpose. International service learning (ISL) is an instructional method used by physical therapist educators to increase the global perspective of students. Research exploring student experiences with ISL is plentiful, but evaluation of service outcomes from the community partner perspective is lacking. The purposes of this work were to evaluate the impact of a long-term community partnership through: (1) identification of benefits, drawbacks, and suggestions for sustaining the partnership and (2) gathering feedback on the immediate and short-term perspective of training provided to orphanage staff. Method/Model Description and Evaluation. The model consisted of a curriculum-based ISL experience involving a US-based physical therapy program and a service site at an Ecuadorian orphanage. For the current work, an evaluation component was added to the model. Three complementary approaches: the SOFAR Model, Exchange theory, and the partnership qualities of closeness, equity, and integrity informed the evaluation. Data consisted of 6 interviews conducted and 17 surveys administered to Ecuadorian community partner staff/administration. Data were analyzed using qualitative thematic content analysis, descriptive statistics, and paired t tests. Outcomes. Partnership benefits included: iterative pre-trip communication, a respectful and mutually beneficial relationship, capacity building through education, and physical therapy that positively affected the children's quality of life. Drawbacks were the potential for host site dependency due to lack of local capacity, negative impact of new technology on staff workload, and poor treatment carryover. Continued training was identified as critical for building capacity within orphanage staff. Discussion and Conclusion. As more US student teams deliver clinical services abroad, intentional evaluation approaches must include the community partner voice to maximize benefits, minimize burdens, build capacity, and addresses issues of vital importance to the service site.

Achieving Clinical Instructor Competence: A Phenomenological Study of Clinical Instructors' Perspectives Introduction. Defining best practice in clinical education is currently a primary focus of the American Physical Therapy Association and the American Council of Academic Physical Therapy. Although professional standards exist for physical therapist clinical instructors (CIs), there is little published research regarding the pathway to achieving competence as a CI. Moreover, there is currently no published definition for competence as a CI within the profession of physical therapy (PT). This study attempts to describe the meaning of competence and the experience of achieving competence as perceived by both credentialed and noncredentialed CIs. Subjects. Twenty-nine physical therapist CIs who had independently supervised at least one full-time physical therapist student served as the subjects for this study. Methods. A phenomenological methodology was used to understand and interpret the meaning of CI competence and the experience of achieving competence from the CI participants' perspectives. Data were collected through focus group interviews and written statements and then were analyzed using thematic analysis. Results. The journey to competence, though unique to each CI, included commonalities. An overarching theme of “Empowerment” emerged from the data analysis and was supported by 6 subthemes: (1) the meaning of competence, (2) my first student, (3) finding the way, (4) barriers to achieving competence, (5) confidence, and (6) lifelong learning. Participants' descriptions of the meaning of competence included the roles of skilled clinician, teacher, mentor, reflective learning, collaborator, and effective communicator. Discussion and Conclusion. Findings can inform CIs striving for effectiveness in clinical teaching by defining the meaning of competence, as well as revealing a variety of pathways used to achieve competence. These examples could be helpful for Site Coordinators of Clinical Education, Directors of Clinical Education and others who teach CI development. The physical therapy education community and its professional bodies can use these findings to define CI competence and to direct future efforts and programs designed to prepare clinicians to effectively educate students in the clinical setting.

Enhancing Pediatric Education for Physical Therapy Students Through the Development of Community Partnerships to Facilitate Experiential Learning: A Case Report Background and Purpose. Doctoral physical therapy (DPT) programs are expected to provide students with educational experiences in classroom and in clinical settings and with all age demographics, including pediatrics. There is significant discrepancy in the delivery and assessment of pediatric content in DPT programs. One effective and evidence-based strategy to address this discrepancy and deliver pediatric content is experiential learning (EL). Our case report illustrates how EL with a symbiotic community partner can enable DPT programs to effectively address the current limitations in direct contact hours and clinical experiences in pediatrics. Case Description. We formed a structured and formal partnership with a local community fitness and gymnastics facility to provide our students with pediatric EL opportunities outside of the classroom and traditional clinic settings. Each student is required to engage in structured and focused play-based interactions with typically and atypically developing children 1 hour per week for two 8-week EL periods under direct supervision of a certified pediatric clinical specialist. Outcomes. Students demonstrated appropriate professional behaviors, increased self-efficacy, achievement of the pediatric course learning objectives, and attainment of 3 Academy of Pediatric Physical Therapy essential core competencies. With our community partner, 87% of the children demonstrated improvement in their gross motor skills. Discussion and Conclusion. Our case report details an innovative approach to use EL to increase the number of direct contact hours with the pediatric population through a symbiotic community partnerships that positions our students to reach entry-level competency with the pediatric population upon graduation.

Establishing the Reliability of a Tool for Assessing Israeli Physical Therapy Students' Clinical Performance Introduction. The evaluation of students' abilities in the clinical setting requires the use of a valid and reliable assessment tool. The assessment tool currently used for this purpose in all physical therapy (PT) undergraduate programs in Israel has never been evaluated for these parameters. This study aimed to find an established assessment tool, translate it into Hebrew, and determine the inter-rater reliability of the translated version and whether it could be a viable substitute for the currently used assessment tool. Review of the Literature. Revealed that the Assessment of Physiotherapy Practice (APP) is an established, valid, and reliable assessment tool. Subjects. Assessors: 21 clinical educators; assessed: 30 undergraduate PT students. Methods. The APP was translated into Hebrew using the translation–retranslation method. Clinical educators were briefly trained to use the APP before the study. Following 8 weeks of clinical practice in an assigned outpatient clinic, each student was assessed by 2 clinical educators, each of whom used both the APP and the currently used assessment tool. Intraclass correlation coefficient (ICC) was used to measure the inter-rater reliability of the APP. Cronbach's alpha was used to measure the internal consistency of the sections of the APP. Percentage of agreement between assessors was measured for each item. Results. The ICC for the total APP was 0.88 (95% confidence interval: 0.77–0.94). The internal consistency of APP sections ranged from 0.65 to 0.93 Cronbach's alpha. Exact agreement between assessors on 12 of the 20 items was identical in 63% or more occasions. Discussion and Conclusion. The ICC for the total score on the Hebrew APP was similar to that of the original APP, and the percentage of agreement among assessors was slightly lower than that of the original version. The latter may be due to the educators' limited experience with this assessment tool. The inter-rater reliability and validity of the Hebrew APP established it as a good substitute for the currently used assessment tool.