JOPTE

The Journal of Physical Therapy Education (JOPTE) is peer reviewed and published four times each year by theEducation Section of the American Physical Therapy Association. The Journal is indexed by Cumulative Index to Nursing & Allied Health Literature and in Physiotherapy Indexditor:

Editors:
Jan Gwyer, PT, PhD
Laurita M. Hack, PT, DPT, MBA, PhD 

2016 Volume 30 - Number 2

Editorial: Good Works
by Jan Gwyer, PT, PhD, FAPTA, and Laurita M. Hack, PT, DPT, PhD, MBA, FAPTA
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This issue is full of examples of this axiom.....
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Guest Editorial: The Continuing Conversation on Educational Research in Physical Therapy
by Jan Gwyer, PT, PhD, FAPTA, and Laurita M. Hack, PT, DPT, PhD, MBA, FAPTA
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Over the past several issues, we have discussed the need to strengthen educational research in physical therapy education. At APTA’s 2016 Combined Sections Meeting, Drs Jan Gwyer, Rick Segal, and Gail Jensen presented views on this topic from the perspectives of JOPTE editor, senior educational researcher, and senior clinical sciences researcher, respectively. They discussed the gaps between what is desired and what is actually happening, along with many suggestions for improvement. Dr Hack then turned to the audience to ask for their suggestions about how to improve the status of educational research in physical therapy education.
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Improvements in Cultural Competence Through Classroom and Local Cross-Cultural Service-Learning Activities
by Jason M. Denton, PT, DPT, MS, Shandra Esparza, EdD, ATC, LAT, David S. Fike, PhD, Jaime Gonzalez, PT, DPT, OCS, SCS, and Melinda Lundquist Denton, PhD
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Introduction. Improving cultural competence has been proposed as a way to decrease health disparities and is a priority of physical therapist (PT) education programs. Multiple published works describe curricular design for PT education programs to promote cultural competence, but limited data support the effectiveness of classroom or local cross-cultural activities. Subjects. Fifty-two first-year PT students participated in the study. Methods. All participants completed an Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCCSV ©) pretest for a baseline measure of cultural competence and an IAPCC-SV© posttest 1 after a classroom educational module including readings, limited lecture, discussions, application activities, and self-reflection. Fifty-one participants completed a second IAPCC-SV© posttest after participating in two 2-hour local cross-cultural activities providing wellness assessments and recommendations for local refugee clients. Results. PT students demonstrated improvement in overall cultural competence, cultural knowledge, and cultural skill after participating in classroom activities. Participation in local, cross-cultural activities resulted in additional improvements in overall cultural competence. The combination of classroom and local, cross-cultural activities resulted in greater improvements in overall cultural competence and each individual category. Discussion and Conclusion. The current results provide support for using classroom activities to improve cultural competence in PT students. Local crosscultural experiences may provide an alternative and/or complimentary option to international service-learning trips for improving cultural competence. The current combination of classroom and local cross-cultural activities was effective for promoting comprehensive improvements in cultural competence. Key Words: Cultural competence, Curriculum design, Cross-cultural experience.
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Social Media and Mobile Technology Use Among Physical Therapist Students: A Multisite Descriptive Study
by Kendra Gagnon, PT, PhD, Carla Sabus, PT, PhD, Eric Robertson, PT, DPT, OCS, FAAOMPT, and Mary K. Derrick, PT, DPT
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Background. Advances in mobile and web-based technologies have changed the way that health information is accessed and shared. However, technology utilization among physical therapist (PT) students remains unclear. Objective. The purpose of this study was to describe technology utilization and comfort with use among PT students in the United States. Design. This was a cross-sectional study. Methods. Students in 3 PT programs were invited to participate in a paperbased survey on social media and smartphone/ tablet use. Results. In all, 299 PT students completed the survey. Of that total, 83% of students owned a smart phone and 34% owned a tablet. Primary uses of mobile devices were to send and receive text messages and email and to access social media. On a daily basis, 84% of respondents reported using Facebook for personal purposes, 49% for academic purposes, and 12% for professional purposes. Similar trends were observed for Twitter and LinkedIn. Eighteen percent of students reported they felt comfortable using social media for professional purposes. Eighty-four percent agreed that smartphones and tablets would be part of their future practice, but only 16% indicated they had received instruction on mobile and internet technology competencies. Limitations. The findings of this study may be limited by response bias and may not reflect technology competency and utilization of the population of doctor of physical therapy (DPT) students. Conclusions. PT students primarily use mobile devices and social media for personal purposes. Few students feel comfortable using these technologies for professional purposes despite the fact that they overwhelmingly anticipate that they will use them in future practice. Educators should consider including mobile technology and social media use in the PT curriculum to prepare students for professional application of technology tools. Key Words: Instructional technology, Professional issues, Technology in physical therapist education.
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Strategies for Using the APTA Section on Research Evidence-Based Practice Curriculum Guidelines
by Sandra L. Kaplan, PT, DPT, PhD, Julie K. Tilson, PT, DPT, MS, NCS, David Levine, PT, DPT, PhD, OCS, Steven Z. George, PT, PhD, Deanne Fay, PT, DPT, MS, PCS, Laurita Hack, PT, DPT, PhD, MBA, FAPTA, Dianne V. Jewell, PT, DPT, PhD, and Rob Wainner, PT, FAAOMPT, PhD
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Background and Purpose. The Doctor Of Physical Therapy Education Evidence- Based Practice Curriculum Guidelines were published in March 2014 by the Evidence Based Practice Special Interest Group (EBP SIG) of the American Physical Therapy Association (APTA) Section on Research. The EBP Curriculum Guidelines describe the recommended minimum standards for EBP terminal be haviors and define common language and content to integrate throughout a physical therapist (PT) education curriculum. The 3 purposes of this paper are to describe (1) a rationale for adoption of the EBP Curriculum Guidelines by academic programs, (2) the process used to create the Guidelines, and (3) strategies for PT education programs to use the Guidelines for curriculum evaluation, student assessment, and faculty assessment and development. Position and Rationale. The EBP Curriculum Guidelines should be considered for adoption by all PT education programs. EBP is an expected and valued skill of PTs. Academic programs have independently determined the breadth and depth of EBP content to integrate into their curricula. EBP paradigms, methods, and resources have evolved over time. The evolution of resources and the variation in program implementation have resulted in variations in curriculum content and student skills. A guideline with expected terminal behavioral objectives and examples of classroom and clinical educational objectives may help to standardize the skill sets of new graduates. Discussion and Conclusion. The development process and structure of the EBP Curriculum Guidelines are described to orient readers to the linked document. Strategies for using the Guidelines for curriculum content evaluation, content mapping, timing and levels of student assessment, academic core faculty and clinical faculty preparation, and overall program outcome assessment are briefly reviewed. This consensus document may change as EBP methods or physical therapy core documents evolve; it currently represents an explicit curriculum guideline appropriate for PT education. Key Words: Evidence-based practice, Entry- level education, Curriculum design, Professional development.
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Integrating Safe Patient Handling Into Physical Therapist Education: Reducing the Incidence of Physical Therapist Injury and Improving Patient Outcomes
by Ellen Perlow, PT, DPT, Niamh Tunney, PT, DPT, MS, and Ann Lucado, PT, PhD, CHT
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Background and Purpose. Work-related musculoskeletal disorders (WMSDs) pose a significant problem for physical therapists (PTs). Safe patient handling (SPH) programs were initiated to guide health care institutions in the safe and effective movement of patients with impaired mobility in an effort to reduce WMSDs in health care workers. The purpose of this position paper is to summarize the rationale for explicitly incorporating information related to SPH in PT education to decrease WMSD injuries, to improve patient outcomes through increased use of SPH equipment as therapeutic tools, and to provide a framework for incorporating SPH content into PT education. Position and Rationale. It is important that educators consider thoroughly incorporating current concepts related to SPH practice in the clinical environment into their courses to ensure student understanding of SPH policies, to enhance their ability to make sound clinical decisions, and to ensure their competence in the use of current SPH technology. SPH programs have been shown not only to reduce WMSDs in health care workers, but also to improve patient outcomes through the strategic use of SPH equipment as a part of therapeutic interventions. It is the responsibility of PT educators to teach students to incorporate SPH practices and to use sound clinical reasoning to avoid personal and patient injury. Discussion. A challenge for educators is that there is very little guidance on how to integrate SPH content into the PT education curriculum. The Normative Model of Physical Therapist Professional Education is used as a framework for a proposed strategy to thread SPH content in PT education. Conclusions. Given the incidence of among PTs, we have a responsibility to promote use of SPH equipment when it will benefit either the patient or the health care worker, or both. Physical therapist educators can influence future attitudes and practice by preparing student PTs to make sound clinical decisions about the use of both manual and mechanicallyassisted patient mobility. Key Words: Safe patient handling (SPH) policies, Work-related musculoskeletal disorders (WMSDs), Clinical instructors (CI).
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Effect of Clinical Experience on Comprehensive Examination Performance in a Physical Therapist Education Program
by Cynthia Utley, PT, DPT, Suzanne Robben Brown, PT, PhD, MPH, and S. Juanita Robel, PT, MHS
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Background and Purpose. There have been considerable attempts to identify factors that predict successful outcomes in physical therapist (PT) education programs. Academic achievement and clinical proficiency are among the factors that have been studied. The impact of clinical education experience (CEE) on student cognitive knowledge has not been evaluated. The purpose of this study was to determine if the focus of an integrated full-time CEE in a predominately musculoskeletal, neurological, or acute care setting has an effect on cognitive knowledge as measured by comprehensive examination scores. Participants. This retrospective study examined records of 194 third-year PT students from 1 entry-level doctoral program. The participants were from 4 different cohorts from 2010–2013. Methods. The CEE focus, comprehensive examination scores, and student course grades were collected from 2 separate program data bases for each cohort. The participants were stratified into 3 groups based on the focus of the full-time CEE in acute care, neurological, or orthopedic settings. A multivariate analysis of variance was conducted to determine whether there was a correlation between the focus of CEEs and the subsequent aggregate and content scores achieved on a programspecific written comprehensive examination. The relationship between academic course grades and comprehensive examination scores was explored using a Pearson correlation analysis. Results. No significant difference was found between the focus of CEEs and content or aggregate scores on the comprehensive examination (F = .896, P = .569). Small to moderate positive correlations were found between academic course grades and comprehensive examination content scores. A large positive correlation was found between all academic course grades and aggregate comprehensive examination scores. Discussion and Conclusion. CEEs provide PT students the opportunity to integrate and utilize knowledge gained during the didactic curriculum and improve skills; however, CEEs may not impact cognitive knowledge as measured by performance on a written examination. Results of this study suggest a specific focus of a full-time CEE does not influence PT student performance on a program-specific written comprehensive examination. Given these results, full-time CEEs in each focus area may not be necessary for PT students to achieve positive outcomes on a cognitive knowledge-based examination. Key Words: Clinical education, Entrylevel education, Student outcomes, Comprehensive examinations.
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Physical Therapists’ Perceptions of Mindfulness for Stress Reduction: An Exploratory Study
by Annette M. Willgens, PT, EdD, MA, PCS, Shona Craig, PT, DPT, Monique DeLuca, PT, DPT, Cali DeSanto, PT, DPT, Annmarie Forenza, PT, DPT, Tyler Kenton, PT, DPT, Elizabeth Previte, PT, DPT, Courtney Woytovich, PT, DPT, ATC, and Gregory Yakimec, PT, DPT
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Literature Review. The purpose of this study was to explore how physical therapists (PTs) conceptualize the theory and evidence-based practice of mindfulness as a means for stress reduction in a clinical setting. Method. Using theoretical sampling and a grounded theory approach, 8 PT students in their final clinical experience recruited 8 PTs to participate in weekly mindfulness activities. They interviewed participants in week 12. Interview questions explored participant thoughts and feelings about mindfulness, including how the activities influenced their professional lives, health habits, and ability to manage stress. After graduation, coauthors analyzed data with the principal investigator (AW) using the constant comparative method. The process of learning about mindfulness is depicted in a series of pictures and is based on themes from coded interview data. Results. Four themes emerged from the data. Theme 1 (I Need to Fix This) characterized a desire to manage stress with a tangible strategy. Theme 2 (I Pause and I Notice but this is Hard) characterized awareness of difficult thoughts and emotions. Theme 3 (Mindfulness Works) emerged as participants shared direct benefits from practicing the tenants of mindfulness. Theme 4 (I Need Support) characterized the desire to be led by an expert, in an ongoing fashion, with the comfort of others to share the experience. Conclusion. Altogether, these data suggest that PTs embraced this evidencebased strategy to practice self-care within and outside of the clinic. Ideally, mindfulness should be introduced early in the PT education program and practiced regularly to minimize student stress. It is recommended that students, with instruction from qualified teachers, lead efforts to introduce mindful practice to sites as part of their clinical training. Key Words: Physical therapy, Self-care, Stress, Mindfulness.
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Second Annual Geneva R. Johnson Innovations in Physical Therapy Education Forum: Inspiring Voices to Orchestrate Change in Physical Therapy Education
by Carol M. Davis, PT, DPT, EdD, FAPTA, MS, and Barbara A. Tschoepe, PT, DPT, PhD
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The vision and inspiration of Dr Geneva R. Johnson (Figure 1) led to many innovations in professional education and, by extension, in physical therapy practice and research. The Annual Geneva R. Johnson Innovations in Physical Therapy Education Forum (GRJ Forum) honors Dr Johnson’s prodigious impact on education for physical therapists and provides an opportunity annually for educators to explore options for innovation and change outside the boundaries of tradition or institutional constraint. The annual GRJ Forum was inaugurated in 2014 by the American Council of Academic Physical Therapy (ACAPT) and the Physical Therapy Learning Institute (PTLI) to launch the Education Leadership Conference (ELC), held annually to unite educators in the pursuit of excellence in physical therapy education. Key to its success was the use of appreciative inquiry (AI)1,2 to encourage exploration (rather than problem solving), creativity (rather than imitation) and bold action (rather than maintaining the status quo). The outcomes of the 2014 GRJ Forum3 excited the continued query of “What If?” as a pathway for discovering new possibilities for transforming the education that supports our profession.
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The Voices of Physical Therapy Education: Orchestrating Timbre, Tempo, and Dynamics
by Susan S. Deusinger, PT, PhD, FAPTA
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Oliver Sacks believed that “music is the profoundest non-chemical medication for our patients”1 Music has the power to heal, to create change, and “set every journey off on the right track.”2 Such journeys, including our professional journeys, have the same rhythm, flow, and patterns that characterize music.3 In my view, the voices that speak to us about purpose and change in physical therapy are a form of music that also can move us, and our profession, forward. My use of a musical analogy is aimed at illustrating the origin and impact of the voices that speak to us about our work, help us understand the urgency to make change, and guide us to organize meaningful action. In essence, we orchestrate change in physical therapy just as a conductor orchestrates a musical performance. It is through this analogy that I will address the origin and impact of the voices that speak to us about our profession and how change must proceed to meet contemporary imperatives for physical therapy. Not only will we enjoy some musical interludes, but we will have time for reflection and incubation of new ideas to catalyze change in physical therapy education.
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