Preparing Clinicians for Roles in Academic Teaching: A Model for Clinical Associated Faculty Development.

PurposeAlternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences.MethodsA descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences.ResultsMean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P < 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21).ConclusionClinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services.

All Doctor of Physical Therapy (DPT) programs in the United States prepare students to demonstrate entry-level clinical performance upon graduation. Clinical residency programs are an option for DPT graduates seeking to specialize in a practice area. There is little research published on why DPT graduates decide to pursue residency education (RE) or not. This study aimed to determine factors influencing a Physical Therapist's (PT) decision-making process in choosing to pursue a postgraduate residency. PTs within 3 years of graduation and third-year DPT program students were surveyed. Most respondents were from DPT programs in the northeastern United States. A survey was created, piloted, and disseminated to various DPT programs. The survey asked participants their perceptions of motivating factors or barriers to pursuing a RE using multiple choice questions and Likert items. Descriptive statistics and frequencies were reported. One-way analysis of variances, chi-square analysis, and unpaired t tests were used. Students who considered residency in their second year are 26.5× more likely to apply for a residency (P < .001). Participants strongly agreed with the statements that residency will increase confidence when practicing in their specialty area (1.39 ± 0.48), expand their knowledge as clinicians (1.39 ± 0.051), and expedite proficient practice (1.72 ± 0.057). Participants considered student burnout, the cost of residency, student loan debt, and geographical relocation as the top barriers to pursuing residency. Men were significantly more confident in their ability to apply to residency (F = 8.219, P = .005). Married individuals perceived loans or financial obligations (F = 3.607, P = .029), family obligations (F = 17.170, P < .001), and geographical limitations (F = 3.825, P = .024) as barriers more than single individuals. There are many variables DPT students and recent graduates consider when deciding whether to pursue RE. RPs and entry-level DPT programs should consider these factors to promote increased participation in postprofessional RE.

Background: Higher education programs that admit students to sequential curricula incur a substantial financial loss when an enrolled student fails to continue in the program for whatever reason. In many instances, the seat cannot be filled, and valuable tuition dollars often over $90,000 per student is lost to the institution. In addition to financial loss, Doctor of Physical Therapy (DPT) programs are required to report and explain rates to the Commission for Accreditation of Physical Therapy Education (CAPTE). Admission committees at Doctor of Physical Therapy programs seek candidates that will be successful in the program and pass the National Physical Therapy Examination (NPTE). Purpose: The purpose of this study was to explore relationships of non-cognitive characteristics (grit and emotional intelligence) and Grade Point Average (GPA) in the first year of a DPT program with the intent to potentially identify students who might benefit from remediation/intervention to prevent attrition. Methods: Forty-two students in the first year of a Doctor of Physical Therapy program completed the Grit scale and the Mayers-Salovey Emotional Intelligence test early in the fall semester of year one. Results: There were no significant relationships between grit or emotional intelligence and academic success in the first year of a DPT program. Conclusions: The current study provides preliminary information related to non-cognitive factors of grit and emotional intelligence and success in a Doctor of Physical Therapy program.

Doctor of Physical Therapy (DPT) programs accept responsibility for the development of clinical skills and professional behaviors in students. Academic and clinical faculty endeavor to teach and mentor at the highest levels. Doctor of Physical Therapy programs that develop leadership intentionally, specifically personal, or self-leadership may be successful in leading positive change within their graduates' relationships, environments, and patient outcomes. Personal leadership means leading from within as an individual and does not require the individual to have a leadership title or role. It includes characteristics such as authenticity, passion, emotional intelligence, trustworthiness, and credibility. This case report will unveil how 1 established residential DPT program integrated personal leadership explicitly as a curricular thread. The 3 pillars are leading self, leading others, and leading systems: organizations and communities. The program used evidence-based processes used to build materials, learning activities, and assessments. The program achieved purposeful integration, including academic/clinical faculty development and progressive student learning experiences. Program assessment through focus groups and curricular surveys shows that students value the curricular content in personal leadership and are meeting the curricular thread behavioral objectives. The personal leadership curricular thread shows promise to promote leadership behaviors in students and graduates.

Up to 15% of U.S. higher education students have a learning disability (LD) such as ADHD, dyslexia, or dysgraphia, which impacts academic skill acquisition. Limited research exists on students with LDs in healthcare science programs, and their representation in Doctor of Physical Therapy (DPT) programs is unknown. This study aimed to explore the presence of students with LDs in Alabama DPT programs and to examine their perceptions of how their LDs impacted them and whether programs provided adequate accommodations. A 12-item online survey was distributed to 326 students across five Alabama DPT programs. Ninety-two students completed the survey; these students were mostly female (n=72) and in the age range of 23-24 years old (n=51). Data revealed that students with LDs were present in these programs. Some reported that their LDs influenced their ability to gain admission and that accommodations during enrollment were insufficient. However, most students felt their LDs would not hinder their clinical practice. The findings suggest that DPT programs should acknowledge the growing presence of students with LDs, address potential barriers to admission, and ensure effective accommodations are provided. Encouraging students to utilize accommodations offices could enhance their academic experience. The confidence of students with LDs in their clinical abilities should inspire both prospective students and DPT programs to support diversity in physical therapy education.

Background and Purpose. Holistic admissions practices may be used to increase diversity in Doctor of Physical Therapy (DPT) programs by consideration of race and ethnicity, educational disadvantaged background, low socioeconomic status, and for persons from geographically underrepresented areas. This study describes the holistic review practices in the DPT program at California State University, Sacramento (CSUS) reports the profile of socioeconomic disadvantage (SED), race, and ethnicity; analyzes the relationships between SED and racial identity; and reports acceptance rates by race and SED. The purpose of this study was to strengthen the evidence-based inclusion practices in the program's admissions processes and to offer a model to DPT programs that are seeking to assess and utilize admissions practices to increase the racial, ethnic, and socioeconomic diversity of the physical therapy profession. Case Description. The holistic review process at CSUS included weighting 4 Skills and Background Characteristics (SBCs) in determining admissions rankings that encompass the socioeconomic variables of the American Council of Academic Physical Therapy's definition of underrepresented minorities (URMs): 1) second language skills, 2) economic background, 3) educational background, and 4) environmental background. Admissions data were collected on all matriculated students in the first 8 years of the program and all qualified applicants in the last 3 years. Retrospective data analyses explored the relationships between SBC scores, race/ethnicity, and acceptance into the DPT program. Outcomes. Nearly 1 in 3 matriculants were the first in their family to graduate from college, and nearly 40% claimed a race/ethnicity other than White alone. Total SBC scores were found to be statistically significantly associated with racial identity and for underrepresented racial minorities (URRMs). Economic, educational, and environmental disadvantages were statistically significantly associated with URRMs. Acceptance into the program was found to be significantly associated with fluency and all SED variables. Discussion and Conclusion. Admissions weighting of SBC factors led to increased linguistic, socioeconomic, and racial diversity. Methods used in this study may serve as a model to other US Doctor of Physical Therapy programs that are seeking to offset the disadvantages that URMs have in gaining acceptance into physical therapist education programs. The expanded use of data-driven holistic admissions practices may contribute to the racial, ethnic, and socioeconomic diversity of the physical therapy profession.

This study uses data from the Physical Therapist Centralized Application Service (PTCAS) to compare influences on application to Doctor of Physical Therapy (DPT) programs between White applicants and people of color (POC)-applicants who identified as Black, American Indian, Asian, Hispanic, or Pacific Islander. This is a retrospective study using holistic narrative analysis. PTCAS data for the 2020 to 2021 application cycle were obtained, including essays and demographic data. Random samples were drawn such that 736 total applicants to PTCAS were included: 372 White applicants and 364 POC applicants. Using categories previously described in the literature, 3 reviewers coded application essays into as many influence categories as applied. Interrater reliability was evaluated on a sample of 12 essays, using Cohen kappa between reviewer pairs and a total arithmetic mean. Chi-square was used to test for difference between groups, based on Bonferroni correction. Personal experience with physical therapy (53.8% for White applicants, 54.9% for POC applicants), observation of the field (68.5% for White applicants, 71.2% for POC applicants), and alignment with values and interests (62.9% for White applicants, 67.3% for POC applicants) were the most common influences. Applicants of color were more likely to indicate a desire to bring services back to their community of origin, formative experience in health care based on race, and paid work experience in the field. Interrater reliability was excellent (.869). Applicants in the POC group were primarily influenced toward pursuing DPT education by personal interaction with physical therapy and alignment of the field with their values. They were more likely than their White peers to have racially based health care experiences, paid work in the physical therapy field, and a desire to provide services to their community. Providing opportunities for people from racial and ethnic minority groups to experience physical therapy through equitable access to physical therapist care, observation hours, internships, or paid work experience may improve enrollment of more diverse cohorts.

Background and Purpose. Since its inception in 1993, professional (entry-level) Doctor of Physical Therapy (DPT) degree has been adopted by a rapidly growing number of programs in United States. The purpose of this study was to provide information on process and status of transition toward DPT in spring 2003, updating and extending a previous study completed in spring 2000. Subjects. Directors of 145 of 191 (76%) accredited physical therapist education programs participated. Method. An Internet-based questionnaire was sent to directors of 191 accredited physical therapist education programs in United States. Results. Of 144 respondents, 119 had made a decision regarding DPT, with 117 of those (98%) deciding in favor of offering DPT degree. Compared to public institutions, a higher proportion of programs at private institutions had decided to implement DPT. Substantially more programs were further along in higher-level approval process than in 2000. Desired characteristics of DPT students at entry were relatively unchanged compared to those desired by programs previously in place at respective institutions. According to questionnaire responses, clinical education characteristics have changed to include: more hours in clinical education, longer duration of each clinical experience, and facilitation of student roles beyond patient care. Almost 90% of DPT programs required either a group or individual culminating scholarly project. Programs' desired faculty characteristics have evolved and put a greater emphasis on a record of publication, establishment of a research agenda, and possession of a doctoral degree other than professional (entry-level) DPT. Discussion and Conclusion. Programs educating physical therapists in United States are transitioning to professional DPT programs at a rate that exceeds prior predictions. While there are still a higher proportion of programs at private than public institutions making transition, other characteristics that once differentiated programs with differing decisions are no longer factors. Key Words: Doctor of Physical Therapy degree, Physical therapist education. BACKGROUND AND PURPOSE Professional (entry-level) education for physical therapists in United States is rapidly changing to Doctor of Physical Therapy (DPT) degree. Initially discussed by Johnson in her Mary McMillan lecture to American Physical Therapy Association (APTA) in 1985,' first professional DPT class was initiated at Creighton University in 1993.2 Barely more than a decade later, Evaluative Criteria adopted by Commission on Accreditation in Physical Therapy Education (CAPTE) indicated that DPT degree was preferred degree to be awarded for completion of a professional physical therapist education program.' The DPT degree is thought to match length and complexity of contemporary physical therapist education as well as provide appropriate preparation for clinical decision-making and diagnostic skills required within contemporary physical therapist practice. The transition to DPT degree has been moving at a pace that is difficult for refereed literature of profession to match. A study conducted by Task Force on Entry-Level Doctoral Education of APTA's Education section was undertaken in spring 2000 and published in 2002. This study, though dated by time of publication, provided insight into process of transition to DPT degree among accredited physical therapist education programs at institutions in United States, and predicted that up to 58 entry-level doctoral programs will exist by 2005.4(p65) However, even in 2000, these authors acknowledged volatile nature of education and practice environments(p61) and anticipated that the nature and pace of transition may undergo substantial change as it unfolds over next several years. …

There is wide variability in the length of full-time clinical education experiences (CEEs) among Doctor of Physical Therapy (DPT) programs. We investigated academic and clinical faculty perspectives on the optimal length and level of agreement on the length, timing, and offering of full-time CEEs. A survey assessing perspectives on the optimal length and level of agreement for the length, timing, and offering of full-time CEEs was completed by 100 academic and 240 clinical faculty. Differences between academic and clinical faculty responses on the optimal length and level of agreement were assessed with a 2-sample test of proportions and 2-sample t -test. Participants believed that the length of full-time CEEs (in weeks) should be single CEE 10.6 (SD 2.3); first CEE 7.8 (SD 2.1); terminal CEE 12.5 (SD 5.4); integrated CEE 9.6 (SD 1.9); and total CEEs 37.2 (SD 6.9). There were significant differences (MD = -3.0; 95% confidence interval [CI] -4.6 to -1.6) between academic and clinical faculty perspectives for the total length of CEEs. No significant differences between academic and clinical faculty perspectives for the length of single, first, terminal, or integrated CEEs. There were significant differences between academic and clinical faculty perspectives for the optimal length of inpatient (MD = 1.1; 95% CI 0.6-1.6) and specialty (MD = 0.8; 95% CI 0.2-1.3) settings. There were significant differences between academic and clinical faculty level of agreement for 8 of 15 items. There was consistency between academic and clinical faculty regarding the perceived optimal length of full-time CEEs. Academic and clinical faculty perspectives for the optimal length of terminal full-time CEEs (12.5 weeks) were different than those for the national average (21.8 weeks) length of terminal full-time CEEs. Our study provides evidence to support DPT programs' clinical education curriculum decisions regarding the length of full-time CEEs to optimize students learning and maturation.

Purpose: Cultural differences and personal biases can affect the way a clinician provides care and the way in which patients receive it. The Commission on Accreditation in Physical Therapy Education (CAPTE) designates cultural competence as one of the professional practice expectations for physical therapy students, although no standardized blueprint exists for Doctor of Physical Therapy (DPT) programs. This case report will illustrate how reflection can be used to facilitate a student’s growth into becoming more prepared to practice in a culturally aware and effective way. In addition, this report seeks to provide a student’s perspective on her efficacy providing culturally competent care, given her training and education through her DPT program. Method: This case report will present the interactions between a student physical therapist (SPT) and a culturally and linguistically diverse patient throughout a physical therapy plan of care. Subsequently, the reflections by the SPT on these interactions will be presented, and themes such as communication barriers, power dynamics, and patient expectations will be explored. Results: Through the student’s self-reflection, she determined both her strengths and areas needing improvement in providing an adequate cross-cultural interaction, in addition to delineating how her preparation in school affected these areas. Her strengths included 1) vulnerability to recognize her own shortcomings, and 2) a desire to create a meaningful connection with the patient. The areas needing improvement included 1) providing an open space for the patient to speak, and 2) setting patient expectations. The student’s DPT program facilitated her preparedness in cultural competence by 1) providing lecture content promoting cultural awareness, 2) encouraging reflection, and 3) hosting an event where the DPT students were able to work with international students of limited-English proficiency. Conversely, barriers to the student’s preparedness included 1) no mandatory community service reaching minority populations, and 2) no opportunity for an abroad immersion experience. Conclusions: Two main themes were drawn from the student’s reflection. First, continual self-evaluation and vulnerability are imperative to the process of becoming a culturally competent provider. Second, clinical experience dedicated to providing care to minority populations appears to be effective in fostering cultural competency in DPT students.

The purpose of this action research study was to investigate Doctor of Physical Therapy (DPT) student stress and psychological distress and improve student wellness through enhancing DPT student coping flexibility and support in the DPT program at a large private urban university. Data from cycle 1 collected from DPT students, faculty and advisors informed action steps in cycle 2. Action steps included a DPT Student Wellness Series, a DPT Faculty Series and a peer mentorship training session. The student wellness series included wellness and coping strategy education and practice on self-care, mindfulness, meditation, nutrition, sleep hygiene, study strategies, time management and a yoga class. The Faculty Series provided faculty with strategies to enhance support and connections with students and included mentoring on the run, growth mindset, difficult conversations, contemplative pedagogy and review of topics presented to students. Students and faculty provided their perspectives on the sessions and changes in coping with stress and/or in their approaches to supporting students. Outcomes of the study revealed that for students and faculty, they experienced improved strategy adaptability indicating they were confident in choosing alternative approaches to coping with stress and supporting students when one strategy wasn't effective. The series validated their current approaches and remained top of mind following it. Participants felt the topics were essential and should be presented in person, on at least a yearly basis and for students, early in the curriculum. The series enhanced connections between students and faculty. Students have been more deliberate about connecting with family and friends to cope with stress. For faculty, connecting with students has become more intentional. The organization should continue to offer the series and consider enhanced support of students through advising. DPT educators should consider implementing similar student wellness and faculty programs and evaluate them for their effectiveness. --Author's abstract

The Learning and Study Strategies Inventory (LASSI) is an instrument that measures self-regulated learning. However, it has not been validated for use in entry-level Doctor of Physical Therapy (DPT) learners. The objective of this study was to investigate the validity and reliability of the LASSI in DPT learners. This was a retrospective observational cohort study. Demographic and LASSI data were retrospectively analyzed from 1541 learners enrolled in 5 entry-level DPT programs across the United States. A confirmatory factor analysis (CFA) was conducted to evaluate whether the 60-item LASSI (3rd Edition) demonstrated a valid and reliable factor structure. An exploratory factor analysis (EFA) was used to identify a more succinct set of LASSI scales. Goodness-of-fit indices and reliability coefficients were computed to assess model fit and measurement consistency. CFA revealed that the 60-item LASSI accounted for 46.7% of total score variance. In contrast, EFA identified a revised 47-item version (termed LASSI-DPT) that accounted for 58.1%, indicating improved construct validity. χ2 goodness-of-fit supported the adequacy of the EFA model (χ2 = 3964.1). The revised 47-item LASSI demonstrated excellent internal consistency, with an overall Cronbach alpha of 0.92, compared to 0.78 for the 60-item version. The revised 47-item LASSI-DPT provides a more reliable, concise, and valid assessment compared to the 60-item LASSI, tailored to learning strategies in physical therapist education programs. Factor analysis demonstrated improved construct validity and excellent reliability in a newly developed 47-item version of the LASSI tailored for DPT learners. This shorter instrument may result in decreased survey fatigue and improved measurement accuracy. With its enhanced psychometric properties, the LASSI-DPT may enable DPT programs to better identify learners who need additional support related to self-regulation of learning.

Introduction. Spanish-speaking individuals with limited English proficiency face health disparities. In response, The University of Texas at El Paso (UTEP) Doctor of Physical Therapy (DPT) Program has integrated Spanish training across their curriculum to better serve this population. The purpose of this study was to evaluate the effects of this training. Methods. Participants were first-year students from the UTEP DPT Program. Students enrolled in a required 8-week, 1-credit beginner or advanced Spanish medical terminology course in their first semester. In addition, they practiced Spanish during laboratory and service-learning experiences. The students completed pretests in the first semester and posttests in their fifth semester: self-ratings of their ability to speak, understand, read, and write Spanish; a written Spanish vocabulary test; and a questionnaire about their beliefs and attitudes about Spanish language training. A repeated-measures two-way analysis of variance was used to analyze self-ratings and vocabulary test scores. Descriptive statistics and paired t tests were used to analyze the data from the pre- and post-questionnaires. Results. There were significant improvements in self-ratings of speaking, understanding, reading, and writing Spanish (P &lt; .001). There was significant improvement in vocabulary test scores (P &lt; .001); no significant difference was seen between beginning and advanced students (P = .097). Results from the questionnaires suggest that students recognize personal and professional benefits from learning Spanish. Discussion and Conclusion. This study supports that the UTEP DPT Program's Spanish language training model improved self-ratings of Spanish proficiency and increased Spanish vocabulary. In addition, students had an overall positive attitude about learning Spanish. Future research is indicated to determine whether self-ratings of proficiency are correlated with observed Spanish proficiency in a clinical setting.

Physical therapy education best practice includes the development of adaptive lifelong learners because of a constantly changing health care landscape. The purpose of this study was to identify how self-directed learning (SDL) changes in traditional Doctor of Physical Therapy (DPT) students over the course of the didactic curriculum. The Master Adaptive Learning (MAL) framework has been proposed as a framework that physical therapy educators adopt to create and educate physical therapists who embrace continuous change and build a culture of creativity and innovation. Fifty students from a midwestern DPT program participated in the quantitative portion, and 14 participated in the qualitative portion of the study. A mixed-methods approach was used to assess students' SDL using the Motivated Strategies of Learning Questionnaire (MSLQ) and the Short Grit scale across the 3-year curriculum. Focus group interviews were conducted following quantitative data collection to develop themes and determine relationships of these themes with existing learning paradigms. There was a statistically significant decrease in students' MSLQ scores from the students' first semester to third and sixth semesters. In the sixth and eighth semester, scores stabilized or had limited improvement. Grit scores remained consistent. Themes that emerged from focus group interviews included deep learning, habits of the heart, and vulnerability. Multiple subthemes were also found that overlap with the MAL framework. This study provides preliminary data to understand DPT students' SDL journey in a traditional DPT program and highlights the need for continued research and efforts toward improving SDL strategies in DPT students. Providing students with necessary resources and support to transition to more self-directed behaviors aligns with the recent call to action to infuse the MAL framework into the PT educational continuum.

Introduction and Review of Literature. Physical therapist (PT) and PT assistant (PTA) education programs have historically required preadmission observation hours (ObHr) as an admission requirement. The variability of conditions surrounding ObHr lends itself to investigation. The aims of this study were to (1) identify the perceived value of ObHr to Admission Committee (AC) members, Directors of Clinical Education, current Doctor of Physical Therapy (DPT) students, and PT clinicians, (2) examine the effect that ObHr have on the decision-making process of AC members, and (3) examine the effect that ObHr had on current DPT students’ decisions to pursue a PT career. Subjects. Four stakeholder groups were targeted (N = 4,471). Methods. This descriptive, cross-sectional study utilized surveys to collect quantitative and qualitative data through closed-ended and open-ended questions. This article encompasses the analysis of the quantitative components by analyzing fixed responses on stakeholder surveys. Qualitative findings are reported in a separate article. Results. Perceived purposes of ObHr by stakeholders were as follows: (1) to gain an accurate understanding of the depth and breadth of the profession, (2) to confirm a desire to pursue PT as a profession, and (3) to better understand the roles and responsibilities of PT. The number of necessary ObHr varied among the groups ranging from 0 to 100 hours. Student perception that completing more hours than required would assist in their favorability for acceptance was debunked. Discussion. There was consensus among all groups regarding the perceived purposes. Variability of stakeholder perception of necessary ObHr to achieve goals was revealed. Doctor of Physical Therapy programs should be transparent and clarify the purpose and quantity of required ObHr. Conclusion. Long-standing requirements could be taxing current resources and limiting entry into the profession. Determining the minimum number of necessary ObHr, considering virtual methods, and employing distinct transparency on how ObHr are used in the decision-making process are opportunities for further study to address these issues.